Genitourinary Cancer

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SU_22_2226 - Increasing Utilization of Active Surveillance in Intermediate Risk Prostate Cancer

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Increasing Utilization of Active Surveillance in Intermediate Risk Prostate Cancer
V. Agrawal1, X. Ma2, J. Kang1, and H. Nagar3; 1NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, 2Weill Cornell Medicine, New York City, NY, 3NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY

Purpose/Objective(s): Active surveillance is an accepted management strategy for low risk prostate cancer. Recent randomized trials have demonstrated no difference in prostate cancer specific mortality for patients receiving active surveillance compared to surgery or radiotherapy. The use of active surveillance for intermediate risk prostate cancer is less clear. We analyzed practice patterns of active surveillance in this risk group.

Materials/Methods: Patients with intermediate risk prostate cancer were identified in the National Cancer Data Base (NCDB). Intermediate risk was defined as patients with Gleason score 7 (3+4 or 4+3), PSA 10-20, or T2b-T2c stage. Patients with PSA>20, Gleason score 8 or greater, or T3 stage or greater were excluded. Trend analysis was performed using the Cochrane-Armitage test. Univariate and multivariate analysis were performed using chi-squared test and logistic regression.

Results: A total of 87,097 patients with intermediate risk prostate cancer were identified within the NCDB between 2010-2015. Of these, 4,272 (4.8%) patients underwent active surveillance. Intermediate risk prostate cancer represented 13% of the 32,858 patients who underwent active surveillance during this time. No patients received androgen deprivation as initial therapy. There was a significant increase in the use of active surveillance from 2.7% (2010) to 6.8% (2015) (p<0.001). On univariate and multivariate analysis, active surveillance utilization was associated with older age, Medicaid/Medicare or uninsured patients (vs. private insurance), academic/research centers, and facilities located in New England.

Conclusion: Active surveillance utilization increased between 2010-2015 for patients with intermediate risk prostate cancer. Additional studies are needed to determine patterns of failure for select patients with intermediate risk prostate cancer who receive active surveillance.

Author Disclosure: V. Agrawal: None. X. Ma: None. J. Kang: None. H. Nagar: None.

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