Int J Urol: Active surveillance questionnaire for patients with low- and intermediate-risk prostate cancer

Recently, several long-term results for active surveillance (AS) in patients with low-risk prostate cancer (PCa) have been published, and the long-term safety of AS for low-risk prostate cancer is now well established
.
Currently, the adaptation of AS has been extended to intermediate-risk PCa, and there have been some small studies
on medium-term outcomes in this population.

Recently, researchers from Japan published an article in Int J Urol, where they conducted a nationwide questionnaire survey to understand active surveillance (AS) for low- and intermediate-risk prostate cancer (PCa
).

The study included 922 Japanese hospitals and examined urologists' occupational age, gender, place of work, treatment equipment owned, specialty areas of daily work, specialty areas of urological cancer, and six hypothetical AS cases
.
The cases were classified by Gleason score: 3+3 low-risk PCa, 3+4 intermediate-risk PCa, and 4+3 intermediate-risk PCa, each with or without comorbidities
.
Complications are defined as cardiovascular disease or conditions
requiring anticoagulant therapy.

A total of 1962 questionnaires
were analysed.
Responses for all age groups were distributed
nearly evenly.
Workplaces include general hospitals (49.
4%), university hospitals (40.
3%) and cancer centers (4.
2%)
.
The proportion of AS with low risk/no comorbidities, low risk/comorbidities, intermediate risk 3+4/no comorbidities, intermediate-risk 3+4/comorbidities, intermediate-risk 4+3/no comorbidities, and intermediate-risk 4+3/comorbidities were 90.
5%, 90%, 39.
5%, 48.
7%, 15% and 22%,
respectively.
A background analysis found that the longer urologists worked, the less they recommended AS treatment
for low-risk patients.
In the presence of comorbidities, urologists of all age groups tend to recommend AS, even in the same Gleason class group
.
Urologists at cancer centers recommend AS
more often than their counterparts at general hospitals and university hospitals.

The relationship between physician professional age and recommended AS

In summary, approximately 40% of urologists recommend the use of AS for intermediate-risk cases, confirming that AS is being considered for intermediate-risk patients in Japan.

Original source:

Takuma Kato， Yoichiro Tohi， Tomoko Honda et al.
A national questionnaire survey of Japanese urologists on active surveillance for low- and intermediate-risk prostate cancer.
Int J Urol.
Nov 2022