Active Surveillance Perspectives of Radiation Oncologists, Medical Oncologists and Urologists in the Treatment of Prostate Cancer

OBJECTIVE To evaluate the perspectives of radiation oncologists (ROs), medical oncologists (MOs) and urologists (UROs) towards active surveillance (AS) in the management of prostate cancer (PCa).METHODS A questionnaire with total of 24 questions was sent out via e-mail to the physicians. 244 participants completed the questionnaire. Pearson Chi square test and multivariable logistic regression models were used to identify physicians’ characteristics and attitudes about AS. RESULTS There were 129 UROs (52.9%), 76 ROs (31.1%) and 39 MOs (16%) in the study population. The analysis of the important factors while considering AS showed that prostate cancer risk group (85.7%) was the most commonly considered criteria, followed by patient’s request and compliance (84.8%), life expectancy (76.2%) and sexual activity of the patient (34.8%). The AS was recommended by 86.8% of UROs, 77.6% of ROs and 61.6% of MOs (p=0.002). In multivariate analysis, practicing as ROs (p=0.031) or UROs (p

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1. Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer 2018;103:356–87.
2. Garisto JD, Klotz L. Active Surveillance for Prostate Cancer: How to Do It Right. Oncology (Williston Park) 2017;31(5):333–40, 45.
3. Butler SS, Loeb S, Cole AP, Zaslowe-Dude C, Muralidhar V, Kim DW, et al. United States trends in active surveillance or watchful waiting across patient socioeconomic status from 2010 to 2015. Prostate Cancer Prostatic Dis 2020;23(1):179–83.
4. Klotz L, Vesprini D, Sethukavalan P, Jethava V, Zhang L, Jain S, et al. Long-term follow-up of a large active surveillance cohort of patients with prostate cancer. J Clin Oncol 2015;33(3):272–7.
5. Meunier ME, Eyraud R, Sénéchal C, Gourtaud G, Roux V, Lanchon C, et al. Active Surveillance for Favorable Risk Prostate Cancer in African Caribbean Men: Results of a Prospective Study. J Urol 2017;197(5):1229–36.
6. Wilt TJ, Jones KM, Barry MJ, Andriole GL, Culkin D, Wheeler T, et al. Follow-up of Prostatectomy versus Observation for Early Prostate Cancer. N Engl J Med 2017;377(2):132–42.
7. Hamdy FC, Donovan JL, Lane JA, Mason M, Metcalfe C, Holding P, et al; ProtecT Study Group. 10- Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med 2016;375(15):1415–24.
8. Bill-Axelson A, Holmberg L, Garmo H, Rider JR, Taari K, Busch C, et al. Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med 2014;370(10):932–42.
9. Thomsen FB, Røder MA, Hvarness H, Iversen P, Brasso K. Active surveillance can reduce overtreatment in patients with low-risk prostate cancer. Dan Med J 2013;60(2):A4575.
10.Kim SP, Gross CP, Shah ND, Tilburt JC, Konety B, Williams SB, et al. Perceptions of Barriers Towards Active Surveillance for Low-Risk Prostate Cancer: Results From a National Survey of Radiation Oncologists and Urologists. Ann Surg Oncol 2019;26(2):660–8.
11.El Sebaaly R, Mansour M, Labban M, Jaafar RF, Armache A, Mukherji D, et al. Survey on the practice of active surveillance for prostate cancer from the Middle East. Prostate Int 2020;8(1):41–8.
12.Davis K, Bellini P, Hagerman C, Zinar R, Leigh D, Hoffman R, et al. Physicians’ Perceptions of Factors Influencing the Treatment Decision-making Process for Men With Low-risk Prostate Cancer. Urology 2017;107:86–95.
13.Bokhorst LP, Alberts AR, Rannikko A, Valdagni R, Pickles T, Kakehi Y, et al; PRIAS study group. Compliance Rates with the Prostate Cancer Research International Active Surveillance (PRIAS) Protocol and Disease Reclassification in Noncompliers. Eur Urol 2015;68(5):814–21.
14.Taylor KL, Hoffman RM, Davis KM, Luta G, Leimpeter A, Lobo T, et al. Treatment Preferences for Active Surveillance versus Active Treatment among Men with Low-Risk Prostate Cancer. Cancer Epidemiol Biomarkers Prev 2016;25(8):1240–50.
15.Gorin MA, Soloway CT, Eldefrawy A, Soloway MS. Factors that influence patient enrollment in active surveillance for low-risk prostate cancer. Urology 2011;77(3):588–91.
16.Kinsella N, Stattin P, Cahill D, Brown C, Bill-Axelson A, Bratt O, et al. Factors Influencing Men’s Choice of and Adherence to Active Surveillance for Low-risk Prostate Cancer: A Mixed-method Systematic Review. Eur Urol 2018;74(3):261–80.
17.Ganz PA, Barry JM, Burke W, Col NF, Corso PS, Dodson E, et al. National Institutes of Health State-of-theScience Conference: role of active surveillance in the management of men with localized prostate cancer. Ann Intern Med 2012;156(8):591–5.
18.Azmi A, Dillon RA, Borghesi S, Dunne M, Power RE, Marignol L, O’Neill BD. Active surveillance for low-risk prostate cancer: diversity of practice across Europe. Ir J Med Sci 2015;184(2):305–11.
19.Gorin MA, Eldefrawy A, Ekwenna O, Soloway MS. Active surveillance for low-risk prostate cancer: knowledge, acceptance and practice among urologists. Prostate Cancer Prostatic Dis 2012;15(2):177–81.
20.Loeb S, Carter HB, Schwartz M, Fagerlin A, Braithwaite RS, Lepor H. Heterogeneity in active surveillance protocols worldwide. Rev Urol 2014;16(4):202–3.