Pandiaraja Madhumitha, Pryle Isolde, West Leah, Gardner Lucy, Shallcross Olivia, Tay June, Shah Nimish, Gnanapragasam Vincent, Lamb Benjamin W
School of Clinical Medicine University of Cambridge Cambridge UK.
Department of Urology Cambridge University Hospitals NHS Foundation Trust Cambridge UK.
BJUI Compass. 2023 Nov 20;5(4):489-496. doi: 10.1002/bco2.311. eCollection 2024 Apr.
Patients with intermediate-risk prostate cancer are faced with the decision of whether to undergo radical treatment. Decision-making aids, such as Predict Prostate, can empower both clinicians and patients to make treatment decisions with personalised information, but their impact on multi-disciplinary team (MDT) decision-making and uptake of radical treatment remains unknown.
The objective of this study is to assess the utilisation and utility of Predict Prostate in informing treatment decisions for patients with intermediate-risk prostate cancer.
A retrospective cohort study was conducted in Cambridge University Hospitals (CUH) of patients referred to the prostate cancer specialist multi-disciplinary team (pcSMDT) and robotic prostatectomy clinic (ROPD) between September 2019 and August 2021 for consideration of radical prostatectomy (RARP). Data on patient characteristics, use of PredictProstate and management decisions were collected from the Epic electronic medical record (EMR) of 839 patients, of whom 386 had intermediate-risk prostate cancer.
The use of Predict Prostate at the pcSMDT increased in the second half of the study period (34.5% vs. 23.8%, < 0.001). The use of Predict Prostate was associated with an increased likelihood of attending ROPD for men with CPG2 prostate cancer (OR = 2.155, 95% CI = 1.158-4.013, = 0.015) but a reduced likelihood of proceeding with RARP for men with CPG2 (OR = 0.397, 95% CI = 0.209-0.753, = 0.005) and CPG3 (OR = 0.305, 95% CI = 0.108-0.861, = 0.025) prostate cancer.
Our study showed that the use of Predict Prostate for patients with intermediate-risk prostate cancer is associated with increased attendance at specialist surgical clinic and a reduced chance of undergoing radical prostate surgery.
中危前列腺癌患者面临是否接受根治性治疗的决策。决策辅助工具，如Predict Prostate，可以为临床医生和患者提供个性化信息，从而帮助他们做出治疗决策，但其对多学科团队（MDT）决策以及根治性治疗的采用率的影响尚不清楚。
本研究的目的是评估Predict Prostate在为中危前列腺癌患者提供治疗决策信息方面的利用情况和效用。
在剑桥大学医院（CUH）进行了一项回顾性队列研究，研究对象为2019年9月至2021年8月期间被转诊至前列腺癌专科多学科团队（pcSMDT）和机器人前列腺切除术诊所（ROPD）以考虑行根治性前列腺切除术（RARP）的患者。从839例患者的Epic电子病历（EMR）中收集了患者特征、PredictProstate的使用情况和管理决策的数据，其中386例患有中危前列腺癌。
在研究期的后半段，pcSMDT对Predict Prostate的使用有所增加（34.5%对23.8%，<0.001）。对于CPG2前列腺癌男性患者，使用Predict Prostate与参加ROPD的可能性增加相关（OR = 2.155，95% CI = 1.158 - 4.013，= 0.015），但对于CPG2（OR = 0.397，95% CI = 0.209 - 0.753，= 0.005）和CPG3（OR = 0.305，95% CI = 0.108 - 0.861，= 0.025）前列腺癌男性患者，进行RARP的可能性降低。
我们的研究表明，对中危前列腺癌患者使用Predict Prostate与专科手术诊所就诊率增加以及接受根治性前列腺手术的机会减少有关。
