For veterans with early-stage prostate cancer, patient age and tumor risk were found to be more strongly associated with use of expectant management than patient comorbidity, a new study published online ahead of print in the journal Cancer has shown.1
Although aggressive treatment can result in bothersome urinary and sexual adverse events without providing significant survival benefit for certain men with low-risk prostate cancer, expectant management is under-utilized. Therefore, researchers sought to evaluate the association between various factors and expectant management use among veterans with early stage prostate cancer.
Results showed that expectant management use was more common for patients 75 years or older and those with low-risk tumors.
Compared with the 27% of patients younger than 55 years who received this approach, 40% of those 75 or older received expectant management. Similarly, 49% of patients with low-risk tumors received expectant management compared with only 20% of those with high-risk tumors.
Researchers found no association between patient comorbidity and expectant management use or any association between facility factors and use of expectant management (P>.05).
The study demonstrated, however, that receipt of expectant management varied significantly across individual facilities among ideal candidates for expectant management (P<.001).
“Research determining the basis of this variation, with a focus on providers, will be critical to help optimize prostate cancer treatment for veterans,” the authors conclude.
1. Filson CP, Shelton JB, Tan HJ, et al. Expectant management of veterans with early-stage prostate cancer [published online ahead of print November 5, 2015]. Cancer. doi:10.1002/cncr.29785.