Surveillance more likely with multidisciplinary PCa care

Multidisciplinary care is associated with increased selection of active surveillance in men with low-risk prostate cancer, according to a recent study.

This finding may have an important clinical, social, and economic impact, concluded the authors, who published their findings online in the Journal of Clinical Oncology (July 30, 2012).

The study, conducted by researchers from Massachusetts General Hospital, Dana-Farber Cancer Institute, and Brigham and Women’s Hospital, Boston, included 701 men with low-risk prostate cancer managed at three tertiary care centers in Boston in 2009. Patients either obtained consultation at a multidisciplinary prostate cancer clinic, at which they were seen by a combination of urologic, radiation, and medical oncologists in a concurrent setting, or they were seen by individual practitioners in sequential settings.

Crude rates of selection of active surveillance in patients seen at a multidisciplinary clinic were double that of patients seen by individual practitioners (43% vs. 22%), whereas the proportion of men treated with prostatectomy or radiation decreased by approximately 30% (p

On multivariate logistic regression, several factors were significantly associated with use of active surveillance, including older age (odds ratio [OR]: 1.09; 95% CI: 1.05 to 1.12; pp=.04), increased Charlson comorbidity index (OR: 1.37; 95% CI: 1.06 to 1.77; p=.02), fewer positive cores (OR: 0.92; 95% CI: 0.90 to 0.94; pp=.02).

"There is no doubt that different environments could sway men toward different treatment choices," senior author Jason Efstathiou, MD, DPhil, of Massachusetts General Hospital, told Reuters Health.

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