BACKGROUND: This study aimed to survey urologists regarding their knowledge, acceptance and practice of active surveillance (AS) for low-risk prostate cancer. METHODS: An email-based survey was distributed to 4987 urologists. Respondents were surveyed regarding their knowledge and acceptance of AS. Those who felt AS was a reasonable strategy were asked their opinions on the criteria for AS enrollment and the details of their practice of AS. Respondents who felt AS was not a reasonable alternative were queried as to the reasons why. RESULTS: A total of 425 (9%) urologists successfully completed the survey and 387 (91%) were both familiar with AS and aware that AS differed from watchful waiting. Of this latter group, 370 (96%) respondents felt AS was a reasonable management strategy, 95% of whom manage patients with this approach. A minority of respondents (6%) felt that patients with a PSA>10 ng ml(-1) were eligible for AS. Further, most participants (74%) felt that patients required a Gleason score ≤6. There was little agreement on the timing of follow-up biopsies. Respondents who objected to AS were most commonly concerned with missing an opportunity for curative treatment (76%) and the risk of tumor undergrading (65%). CONCLUSIONS: The majority of participants were knowledgeable and accepting of AS. Respondents were in relative agreement regarding the PSA and Gleason score criteria for AS enrollment. In contrast, there was a lack of agreement on the timing of follow-up biopsies. In the future, comparative studies are required to determine the optimal enrollment criteria and follow-up protocol for patients managed with AS.
BACKGROUND: This study aimed to survey urologists regarding their knowledge, acceptance and practice of active surveillance (AS) for low-risk prostate cancer. METHODS: An email-based survey was distributed to 4987 urologists. Respondents were surveyed regarding their knowledge and acceptance of AS. Those who felt AS was a reasonable strategy were asked their opinions on the criteria for AS enrollment and the details of their practice of AS. Respondents who felt AS was not a reasonable alternative were queried as to the reasons why. RESULTS: A total of 425 (9%) urologists successfully completed the survey and 387 (91%) were both familiar with AS and aware that AS differed from watchful waiting. Of this latter group, 370 (96%) respondents felt AS was a reasonable management strategy, 95% of whom manage patients with this approach. A minority of respondents (6%) felt that patients with a PSA>10 ng ml(-1) were eligible for AS. Further, most participants (74%) felt that patients required a Gleason score ≤6. There was little agreement on the timing of follow-up biopsies. Respondents who objected to AS were most commonly concerned with missing an opportunity for curative treatment (76%) and the risk of tumor undergrading (65%). CONCLUSIONS: The majority of participants were knowledgeable and accepting of AS. Respondents were in relative agreement regarding the PSA and Gleason score criteria for AS enrollment. In contrast, there was a lack of agreement on the timing of follow-up biopsies. In the future, comparative studies are required to determine the optimal enrollment criteria and follow-up protocol for patients managed with AS.
Authors: G I Russo; T Castelli; V Favilla; G Reale; D Urzì; S Privitera; E Fragalà; S Cimino; G Morgia Journal: Prostate Cancer Prostatic Dis Date: 2015-06-02 Impact factor: 5.554
Authors: Charlotte J Hagerman; Paula G Bellini; Kim M Davis; Richard M Hoffman; David S Aaronson; Daniel Y Leigh; Riley E Zinar; David Penson; Stephen Van Den Eeden; Kathryn L Taylor Journal: Health Educ Res Date: 2017-04-01
Authors: Stacy Loeb; Caitlin Curnyn; Angela Fagerlin; Ronald Scott Braithwaite; Mark D Schwartz; Herbert Lepor; Herbert Ballentine Carter; Erica Sedlander Journal: BJU Int Date: 2016-10-02 Impact factor: 5.588
Authors: Sue-Ing Quek; Melissa E Ho; Michelle A Loprieno; William J Ellis; Nathan Elliott; Alvin Y Liu Journal: PLoS One Date: 2012-09-20 Impact factor: 3.240
Authors: Claire Kim; Frances C Wright; Nicole J Look Hong; Gary Groot; Lucy Helyer; Pamela Meiers; May Lynn Quan; Robin Urquhart; Rebecca Warburton; Anna R Gagliardi Journal: PLoS One Date: 2018-02-05 Impact factor: 3.240