Treatment choice for localized prostate cancer is complicated, as each treatment option comes with various pros and cons. It is well established that active surveillance (AS), may be ended with a change to curative treatment at the time of disease progression, but it is less clear whether secondary treatment after initial curative treatment is required. As part of the PIONEER project, we quantified the probabilities of treatment change.
A cohort study based on PRIAS and ERSPC-Rotterdam data was conducted. Patients were followed up for 10 years or until the 31st of December 2017. The primary outcome was the incidence of treatment change following initial treatment (i.e., a change to curative treatment following AS or secondary treatment after initial RP/RT).
Over a period of 1 to 5 years after initial treatment, the cumulative incidence of treatment change ranged from 3.8% to 42.8% for AS, from 7.6% to 12.1% for radical prostatectomy (RP) and from no change to 5.3% for radiation therapy (RT). While the possibility of treatment change in AS is known, the numbers within a five-year period were substantial. For RP and RT, the rate of change to secondary treatment was lower, but still non-neglectable, with 5 (10)-year incidences up to 12% (20%) and 5% (16%), respectively.
This is one of the first studies comparing the incidence of guideline-recommended treatment changes in men receiving different primary treatments (i.e., AS, RT, or RP) for localized prostate cancer (PCa).
Journal of personalized medicine. 2022 May 05*** epublish ***
Katharina Beyer, Vera Straten, Sebastiaan Remmers, Steven MacLennan, Sara MacLennan, Giorgio Gandaglia, Peter-Paul M Willemse, Ronald Herrera, Muhammad Imran Omar, Beth Russell, Johannes Huber, Markus Kreuz, Alex Asiimwe, Tom Abbott, Alberto Briganti, Mieke Van Hemelrijck, Monique J Roobol
Translational and Oncology Research (TOUR), King's College London, Faculty of Life Sciences and Medicine, London SE19RT, UK., Department of Urology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands., Academic Urology Unit, University of Aberdeen, Aberdeen AB24 3FX, UK., Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy., Department of Urology, Cancer Center, University Medical Center Utrecht, 3584 Utrecht, The Netherlands., Integrated Evidence Generation-Data Science, Research & Analytics, Bayer AG, 13353 Berlin, Germany., Department of Urology, University of Technology, 01069 Dresden, Germany., Department of Diagnostics, Fraunhofer Institute for Cell Therapy and Immunology, 04103 Leipzig, Germany., Department of Epidemiology, Bayer AG, 13353 Berlin, Germany., Real World Evidence, Astellas Pharma, 2333 Leiden, The Netherlands.