OBJECTIVES: To determine the accuracy of clinicians' predictions of life expectancy in patients with localized prostate cancer, when provided with information about age and comorbidity, and to determine whether life expectancy estimates predict the choice of initial treatment. METHODS: A survey was sent by facsimile to 191 Canadian urologists and radiation oncologists asking them to estimate the life expectancy and choose the initial therapy (radical prostatectomy, radiation, or watchful waiting) for 18 patient scenarios: two prostate cancer scenarios, each with three ages and three levels of comorbidity. RESULTS: Life expectancy estimates were accurate within 1 year of the projections of a Markov model for 31% of the clinicians' responses and accurate within 3 years for 67% of the responses. The average prediction error ranged from 2.4 to 5.2 years. The life expectancy was correctly estimated as being greater than or less than 10 years in 82% of responses. Ten years was the minimal life expectancy for recommending surgery and within the range (5 to 15 years) in which radiation was recommended. CONCLUSIONS: Clinicians can use age and comorbidity to predict the life expectancy of patients with localized prostate cancer with a modest degree of overall accuracy, but with sufficient accuracy to use the "10-year rule." Life expectancy estimates are strongly associated with treatment choice. The appropriateness of the 10-year rule remains to be determined.
OBJECTIVES: To determine the accuracy of clinicians' predictions of life expectancy in patients with localized prostate cancer, when provided with information about age and comorbidity, and to determine whether life expectancy estimates predict the choice of initial treatment. METHODS: A survey was sent by facsimile to 191 Canadian urologists and radiation oncologists asking them to estimate the life expectancy and choose the initial therapy (radical prostatectomy, radiation, or watchful waiting) for 18 patient scenarios: two prostate cancer scenarios, each with three ages and three levels of comorbidity. RESULTS: Life expectancy estimates were accurate within 1 year of the projections of a Markov model for 31% of the clinicians' responses and accurate within 3 years for 67% of the responses. The average prediction error ranged from 2.4 to 5.2 years. The life expectancy was correctly estimated as being greater than or less than 10 years in 82% of responses. Ten years was the minimal life expectancy for recommending surgery and within the range (5 to 15 years) in which radiation was recommended. CONCLUSIONS: Clinicians can use age and comorbidity to predict the life expectancy of patients with localized prostate cancer with a modest degree of overall accuracy, but with sufficient accuracy to use the "10-year rule." Life expectancy estimates are strongly associated with treatment choice. The appropriateness of the 10-year rule remains to be determined.
Authors: Vickie L Shavers; Martin L Brown; Arnold L Potosky; Carrie N Klabunde; W W Davis; Judd W Moul; Angela Fahey Journal: J Gen Intern Med Date: 2004-02 Impact factor: 5.128
Authors: Giovanni Lughezzani; Alberto Briganti; Pierre I Karakiewicz; Michael W Kattan; Francesco Montorsi; Shahrokh F Shariat; Andrew J Vickers Journal: Eur Urol Date: 2010-08-06 Impact factor: 20.096
Authors: Bruce L Jacobs; Yun Zhang; Florian R Schroeck; Ted A Skolarus; John T Wei; James E Montie; Scott M Gilbert; Seth A Strope; Rodney L Dunn; David C Miller; Brent K Hollenbeck Journal: JAMA Date: 2013-06-26 Impact factor: 56.272
Authors: Ann S Hamilton; Steven T Fleming; Dian Wang; Michael Goodman; Xiao-Cheng Wu; Jean B Owen; Mary Lo; Alex Ho; Roger T Anderson; Trevor Thompson Journal: Am J Clin Oncol Date: 2016-02 Impact factor: 2.339
Authors: Richard R Drake; Krista Y White; Thomas W Fuller; Elena Igwe; Mary Ann Clements; Julius O Nyalwidhe; Robert W Given; Raymond S Lance; O John Semmes Journal: J Proteomics Date: 2009-01-20 Impact factor: 4.044