Sandoval C, Tran K, Rahal R, Porter G, Fung S, Louzado C, Liu J, Bryant H
Canadian Partnership Against Cancer, Toronto, ON;
Faculty of Medicine, Dalhousie University, Halifax, NS;
Curr Oncol. 2015 Dec;22(6):427-9. doi: 10.3747/co.22.2895.
In general, guideline-recommended treatment options for men with low-risk prostate cancer (pca) include active surveillance, radical prostatectomy, and external-beam radiation therapy or brachytherapy. Because of the concern about overdiagnosis and consequent overtreatment of pca, patients with low-risk disease are increasingly being managed with active surveillance. Using data from six provincial cancer registries, we examined treatment patterns within a year of a diagnosis of localized low-risk pca, and we assessed differences by age. Of patients diagnosed in 2010 in four of the six reporting provinces, most received surgery or radiation therapy within 1 year of diagnosis. Depending on the province, either surgery or radiation therapy was the most commonly used primary treatment. In the other two provinces, most patients had no record of treatment within a year of diagnosis. Examining treatment patterns by age demonstrated a lesser likelihood of receiving surgery or radiation therapy within 1 year of diagnosis among men more than 75 years of age than among men 75 years of age or younger (no record of treatment in 69.1% and 46.3% respectively). In conclusion, we observed interprovincial and age-specific variations in the patterns of care for men with low-risk pca. The findings presented in this report are intended to identify opportunities for improvement in clinical practice that could lead to improved care and experience.
一般而言,低风险前列腺癌(pca)男性患者的指南推荐治疗方案包括主动监测、根治性前列腺切除术、外照射放疗或近距离放射治疗。由于担心前列腺癌的过度诊断及随之而来的过度治疗,低风险疾病患者越来越多地接受主动监测管理。利用来自六个省级癌症登记处的数据,我们研究了局部低风险前列腺癌诊断后一年内的治疗模式,并按年龄评估了差异。在六个报告省份中的四个省份2010年诊断的患者中,大多数在诊断后1年内接受了手术或放疗。根据省份不同,手术或放疗是最常用的主要治疗方法。在另外两个省份,大多数患者在诊断后一年内没有治疗记录。按年龄检查治疗模式表明,75岁以上男性在诊断后1年内接受手术或放疗的可能性低于75岁及以下男性(分别有69.1%和46.3%无治疗记录)。总之,我们观察到低风险前列腺癌男性患者的护理模式存在省际差异和年龄特异性差异。本报告中的研究结果旨在确定临床实践中可改善护理和体验的改进机会。