Mehdi Mokhtar Ariane1, Guillaume Ploussard2, Xavier Rebillard3, Bernard Malavaud4, Pascal Rischmann4, Christophe Hennequin5, Pierre Mongiat-Artus2. 1. Division of Urology, Academic Hospital Saint-Louis, University Paris VII, Paris, France. mehdi.ariane@hotmail.fr. 2. Division of Urology, Academic Hospital Saint-Louis, University Paris VII, Paris, France. 3. Division of Urology, Clinic Beau Soleil, Montpellier, France. 4. Division of Urology, Academic Hospital Rangueil, University Toulouse III, Toulouse, France. 5. Division of Radiation Oncology, Academic Hospital Saint-Louis, University Paris VII, Paris, France.
Abstract
INTRODUCTION: Through a cross-sectional survey, we tried to assess whether practices of urologists and radiation oncologists are uniform when faced with similar clinical situations. MATERIALS AND METHODS: A self-administered questionnaire was mailed to all French urologists and radiation oncologists. Respondents were asked about their practices through 11 case scenarios. The scenarios cover most of localized prostate cancer situations and were gradually organized depending on prostate cancer progression risk and the age of the patient. The eight first scenarios address the situation of treatment-naive patients, and the last cases were about the management of patients after radical prostatectomy. Physicians were asked to choose a treatment modality for each case. The responses were first stratified according to the intention to treat: either curative-intent treatment or palliative. The curative-treatment modality chosen were afterward assessed. The responses to clinical scenarios were compared between the two specialties. RESULTS: Concerning the intention to treat, practice patterns were overall consistent except in one case. Indeed, a higher rate of radiation oncologists prefer curative-intent treatment for intermediate-risk prostate cancer in aged patients: 57.4 versus 14.6 % (p < 0.001). Each medical specialist prefers the treatment that he himself delivers (p < 0.005). For intermediate-risk prostate cancer in 65-year-old patient: 96.5 % of urologists chose radical prostatectomy versus 37.7 % of radiation oncologists (p < 0.001). Fewer urologists (almost 14 %) compared to radiation oncologists (47.5 %) would prescribe adjuvant treatment after radical prostatectomy for T3a R0 prostate cancer with post-operative PSA undetectable (p < 0.001). CONCLUSION: Significant differences were found in therapeutic approach between the two main specialties that deal with localized prostate cancer.
INTRODUCTION: Through a cross-sectional survey, we tried to assess whether practices of urologists and radiation oncologists are uniform when faced with similar clinical situations. MATERIALS AND METHODS: A self-administered questionnaire was mailed to all French urologists and radiation oncologists. Respondents were asked about their practices through 11 case scenarios. The scenarios cover most of localized prostate cancer situations and were gradually organized depending on prostate cancer progression risk and the age of the patient. The eight first scenarios address the situation of treatment-naive patients, and the last cases were about the management of patients after radical prostatectomy. Physicians were asked to choose a treatment modality for each case. The responses were first stratified according to the intention to treat: either curative-intent treatment or palliative. The curative-treatment modality chosen were afterward assessed. The responses to clinical scenarios were compared between the two specialties. RESULTS: Concerning the intention to treat, practice patterns were overall consistent except in one case. Indeed, a higher rate of radiation oncologists prefer curative-intent treatment for intermediate-risk prostate cancer in aged patients: 57.4 versus 14.6 % (p < 0.001). Each medical specialist prefers the treatment that he himself delivers (p < 0.005). For intermediate-risk prostate cancer in 65-year-old patient: 96.5 % of urologists chose radical prostatectomy versus 37.7 % of radiation oncologists (p < 0.001). Fewer urologists (almost 14 %) compared to radiation oncologists (47.5 %) would prescribe adjuvant treatment after radical prostatectomy for T3a R0 prostate cancer with post-operative PSA undetectable (p < 0.001). CONCLUSION: Significant differences were found in therapeutic approach between the two main specialties that deal with localized prostate cancer.
Authors: Michel Soulié; Philippe Beuzeboc; François Cornud; Pascal Eschwege; Nicolas Gaschignard; Pascale Grosclaude; Christophe Hennequin; Philippe Maingon; Vincent Molinié; Pierre Mongiat-Artus; Jean-Luc Moreau; Philippe Paparel; Michel Péneau; Michaël Peyromaure; Vincent Ravery; Xavier Rébillard; Pierre Richaud; Laurent Salomon; Frederic Staerman; Arnauld Villers Journal: Prog Urol Date: 2007-11 Impact factor: 0.915
Authors: Axel Heidenreich; Joaquim Bellmunt; Michel Bolla; Steven Joniau; Malcolm Mason; Vsevolod Matveev; Nicolas Mottet; Hans-Peter Schmid; Theo van der Kwast; Thomas Wiegel; Filliberto Zattoni Journal: Eur Urol Date: 2010-10-28 Impact factor: 20.096
Authors: Simon P Kim; Cary P Gross; Paul L Nguyen; Marc C Smaldone; Nilay D Shah; R Jeffrey Karnes; R Houston Thompson; Leona C Han; James B Yu; Quoc D Trinh; Jeanette Y Ziegenfuss; Maxine Sun; Jon C Tilburt Journal: Med Care Date: 2014-07 Impact factor: 2.983
Authors: Jeffrey J Tosoian; Bruce J Trock; Patricia Landis; Zhaoyong Feng; Jonathan I Epstein; Alan W Partin; Patrick C Walsh; H Ballentine Carter Journal: J Clin Oncol Date: 2011-04-04 Impact factor: 44.544
Authors: Mark S Soloway; Cynthia T Soloway; Ahmed Eldefrawy; Kristell Acosta; Bruce Kava; Murugesan Manoharan Journal: Eur Urol Date: 2010-08-20 Impact factor: 20.096
Authors: Nancy L Keating; Mary Beth Landrum; John Z Ayanian; Eric P Winer; Edward Guadagnoli Journal: J Clin Oncol Date: 2003-12-15 Impact factor: 44.544
Authors: Grace A Lin; David S Aaronson; Sara J Knight; Peter R Carroll; R Adams Dudley Journal: CA Cancer J Clin Date: 2009-10-19 Impact factor: 508.702
Authors: Jan-Erik Johansson; Ove Andrén; Swen-Olof Andersson; Paul W Dickman; Lars Holmberg; Anders Magnuson; Hans-Olov Adami Journal: JAMA Date: 2004-06-09 Impact factor: 56.272
Authors: Matthew J Resnick; Tatsuki Koyama; Kang-Hsien Fan; Peter C Albertsen; Michael Goodman; Ann S Hamilton; Richard M Hoffman; Arnold L Potosky; Janet L Stanford; Antoinette M Stroup; R Lawrence Van Horn; David F Penson Journal: N Engl J Med Date: 2013-01-31 Impact factor: 91.245
Authors: Jared S Fredrickson; Jason R Kolfenbach; Jennifer L Holmes; Jennifer N Cathcart; Anne M Lynch; Alan G Palestine Journal: Obstet Med Date: 2019-01-09
Authors: Jared S Fredrickson; Jennifer Holmes; Jennifer N Cathcart; Anne M Lynch; Jason R Kolfenbach; Alan G Palestine Journal: J Ophthalmic Inflamm Infect Date: 2018-07-03