Wei Yongbao, Liu Longfei, Li Xin, Song Wei, Zhong Dewen, Cao Xiande, Yuan Daozhang, Ming Shaoxiong, Zhang Peng, Wen Yanlin
Shengli Clinical Medical College, Fujian Medical University, Fuzhou 350001, China.
Department of Urology, Fujian Provincial Hospital, No.134 Dong Street, Fuzhou 350001, China.
J Cancer. 2019 Feb 23;10(6):1496-1502. doi: 10.7150/jca.29595. eCollection 2019.
: To analyze the current treatment for low-risk prostate cancer (LRPC) in China. : A national questionnaire survey titled "A survey of current treatment of LRPC" was designed and released nationally through the network from July 16 to August 3, 2017. : A total of 1,116 valid questionnaires were recovered. The percentages of preferred treatment by active surveillance (AS) or radical prostatectomy (RP) were 29.21% and 45.61%, respectively. A correspondence analysis showed that the physician in charge was more inclined to choose AS than RP. Respondents from different institution types, hospitals with different annual numbers of newly admitted patients with prostate cancer, and with different familiarity with the LRPC definition presented a significant difference in the preferred treatments (p < 0.05). Urologists chose AS or not for the following reasons: tumor progression (52.51%), potential medical disputes (42.56%) (i.e., medical disputes from patients or their relatives when urologists choose AS to treat patients with LRPC and the patient has a poor outcome), fear of cancer (41.94%), and surgical risk (39.07%). These reasons were ubiquitous, and there was no significant difference among urologists for these concerns (p > 0.05). Personal skills, surgical risk, and tumor progression were the most common factors that influenced whether AS or RP was preferred (p < 0.05). Concern about the medical disputes brought about by AS was a key factor for not choosing AS (p < 0.05). : LRPC is still dominated by RP in China, followed by AS. Personal skills, surgical risk, and concern about tumor progression were the common factors influencing whether AS or RP was preferred. In addition, medical disputes brought by AS are another key factor for not choosing AS. There will be more Chinese data in the future to guide treatment of LRPC.
分析中国低危前列腺癌（LRPC）的当前治疗情况。设计了一项名为“LRPC当前治疗情况调查”的全国性问卷调查，并于2017年7月16日至8月3日通过网络在全国范围内发布。共回收有效问卷1116份。主动监测（AS）或根治性前列腺切除术（RP）的首选治疗比例分别为29.21%和45.61%。对应分析表明，主管医生更倾向于选择AS而非RP。来自不同机构类型、不同年度前列腺癌新入院患者数量的医院以及对LRPC定义熟悉程度不同的受访者在首选治疗方面存在显著差异（p<0.05）。泌尿外科医生选择AS与否的原因如下：肿瘤进展（52.51%）、潜在医疗纠纷（42.56%）（即泌尿外科医生选择AS治疗LRPC患者且患者预后不佳时来自患者或其亲属的医疗纠纷）、对癌症的恐惧（41.94%）以及手术风险（39.07%）。这些原因普遍存在，泌尿外科医生对这些担忧没有显著差异（p>0.05）。个人技能、手术风险和肿瘤进展是影响首选AS还是RP的最常见因素（p<0.05）。对AS带来的医疗纠纷的担忧是不选择AS的关键因素（p<0.05）。在中国，LRPC仍以RP为主，其次是AS。个人技能、手术风险和对肿瘤进展的担忧是影响首选AS还是RP的常见因素。此外，AS带来的医疗纠纷是不选择AS的另一个关键因素。未来将有更多中国数据指导LRPC的治疗。
