Changing Patterns of Primary Treatment in Korean Men with Prostate Cancer Over 10 Years: A Nationwide Population Based Study

Park, Jinsung; Suh, Beomseok; Shin, Dong Wook; Hong, Jun Hyuk; Ahn, Hanjong

doi:10.4143/crt.2015.212

Cited by 26 publications

(25 citation statements)

References 24 publications

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“…Because RARP is not reimbursed by KNHI, it cannot be identified by that code. Thus, RARP was operationally defined as the absence of a surgery code, despite the presence of general anesthesia (code L1211) and postoperative pathologic examination code (code C5500, C5500, C5501, C5502, C5503, C5504, C5505, C5506, C5507, C5508, C5509, C5911, C5912, C5913, C5914, C5915, C5916, C5917, C5918, C5919) as described previously [11]. Primary ADT included both surgical orchiectomy and medical castration.…”

Section: Methodsmentioning

confidence: 99%

Medical Travel among Non-Seoul Residents to Seek Prostate Cancer Treatment in Medical Facilities of Seoul

Kim

Yun

et al. 2019

Cancer Res Treat

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Section: Methodsmentioning

confidence: 99%

Medical Travel among Non-Seoul Residents to Seek Prostate Cancer Treatment in Medical Facilities of Seoul

Kim

Yun

et al. 2019

Cancer Res Treat

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“…Unfortunately, owing to the procedure codes used by the KNHIS, we could not determine whether RT was performed for curative or palliative purposes. However, RT is rarely performed in Korea as a primary treatment 21 , and significant proportions of patients undergoing RT (RT only or RT + ADT) may have been those who received palliative treatment. Thus, we postulate that in our study PC survivors undergoing www.nature.com/scientificreports www.nature.com/scientificreports/ RT with or without ADT were likely to have been initially diagnosed with metastatic PC, and that their risk of developing CVD would be different from the surgery-only group, which was more likely to have had their PC detected by PSA screening.…”

Section: Discussionmentioning

confidence: 99%

Risk of Ischemic Heart Disease and Stroke in Prostate Cancer Survivors: A Nationwide Study in South Korea

Shin

Han

Park

et al. 2020

Sci Rep

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In this study using national health insurance data, we investigated the risk of ischemic heart disease (IHD) and stroke among prostate cancer (PC) survivors compared with the general population, as well as the risk of cardiovascular disease (CVD) according to primary treatment. A total of 48,298 PC patients diagnosed from 2007 to 2013 were included and matched to non-cancer controls. Compared to the general population, PC survivors had a slightly lower risk of IHD (adjusted hazard ratio [aHR] = 0.89, 95% confidence interval [CI] 0.83-0.96) or stroke (aHR 0.90, 95% CI 0.87-0.95). Especially, survivors who underwent surgery had lower risks of IHD (aHR 0.70, 95% CI 0.61-0.80) or stroke (aHR 0.73, 95% CI 0.67-0.81). Compared to survivors in the active surveillance/watchful waiting group, the androgen deprivation therapy (ADT) group had a significantly greater risk of stroke (aHR 1.16, 95% CI 1.02-1.32), but the IHD risk was not significantly elevated (aHR 1.06, 95% CI 0.88-1.29). In conclusion, PC survivors had a slightly lower risk of CVD compared to the general population, which was attributable to self-selection for PSA screening, specifically in the surgery-only group. CVD risk was dependent on treatment received, and attention should be given to patients who receive ADT. Cancer survivor is defined as any person diagnosed with cancer, from the time of diagnosis until his or her death. With improved survival and the increased number of prostate cancer (PC) survivors 1 , management of comorbidities has become increasingly important for this population 2. Cardiovascular disease (CVD) is reported to be the main cause of mortality in PC survivors in the US, comprising 20% of overall mortality, and surpassing mortality from PC and second primary malignancies 3. In a Korean cohort study, CVD was responsible for 29.1% of non-PC mortality in long-term PC survivors 4. Many studies have analyzed the risk of CVD in PC patients treated with androgen deprivation therapy (ADT) 5-17 , but it is not certain whether PC survivors have a greater risk of CVD compared to the general population. To date, only a few studies have compared the CVD risk between PC survivors and the general population 18-20 , but the results were inconsistent: a Swedish study suggested elevated risk 18 , a UK study reported similar risk 19 , and a US study demonstrated lower risk 20. Among these studies, only the Swedish study analyzed the CVD risk according to treatment modality (i.e., surveillance, curative treatment, endocrine therapy) 18. Thus, the risk of CVD among PC survivors who underwent different types of treatment has not been assessed definitively. In addition, there are no reports from Asian countries, where practice patterns may differ from Western countries 21. To address these limitations, we used a Korean national healthcare database to investigate the CVD risk among PC survivors compared with general population controls, as well as the risk of CVD according to primary treatment. Methods Data Source: Korean national Health insurance Service...

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“…Additionally, a survival benefit has also been found for men at high risk for PCa 14 - 17 . Another reason may be that the majority of Chinese PCa patients are initially diagnosed by urologists; therefore, the dominant use of surgery as a curative therapy may be attributable to clinician factors 18 . Moreover, the introduction of Da Vinci robotic surgery in 2014 increased the number of surgeries in PCa patients and provided another surgical option for the management of patients with PCa, especially for those with high-risk disease.…”

Section: Discussionmentioning

confidence: 99%

Trends in Treatment for Prostate Cancer in China: Preliminary Patterns of Care Study in a Single Institution

et al. 2018

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Objectives: A Patterns of Care Study (PCS) was performed in the largest regional medical center in Zhejiang Province, China. The hospital information system (HIS) was used to evaluate patient characteristics and changes in initial treatment patterns for prostate cancer and to determine recent predominant trends in treatment plans for prostate cancer (PCa) in China.Methods: Men who were newly diagnosed with localized or locally advanced PCa for 2010-2011 and 2016-2017 were identified in the HIS database. Patient characteristics and temporal trends in initial management were assessed, and differences between groups were evaluated for significance using Chi-square and Mann-Whitney U tests.Results: In total, 1792 patients met the study criteria, including 505 and 1287 patients in the 2010-2011 and 2016-2017 samples, respectively. The average age of patients diagnosed in the 2010-2011 PCS survey was 70 years, decreasing to 68 years when the 2016-2017 patients were included (P<0.001). In the 2010-2011 sample, 50.69% of the patients had an initial prostate-specific antigen (PSA) level ≥20 ng/ml. In contrast, the initial PSA level was 4-19.99 ng/ml for 66.67% of the patients in the 2016-2017 sample (P<0.001). Based on National Comprehensive Cancer Network (NCCN) criteria, the percentages of patients in low- and intermediate-risk groups increased from 33.06% to 54.78%; conversely, the percentages in high-risk, very high-risk, and regional (N1) groups decreased to a certain extent (P<0.001). According to European Association of Urology (EAU) criteria, the percentages of patients in low- and intermediate-risk groups increased from 32.07% to 53.69%, yet the percentage in the high-risk group decreased (P<0.001). The use of radical prostatectomy (RP) and radiation therapy (RT) increased from 48.32% to 76.46% and 5.35% to 16.94%, particularly in high-risk and low-risk groups, respectively, whereas the rates of hormone therapy (HT) and active surveillance and observation (AS&O) decreased from 32.28% to 4.27% and from 16.04% to 2.33%, respectively (P<0.001). A similar pattern was observed when patients were stratified by EAU risk group.Conclusions: The results of this real-world study in the largest regional medical center in Zhejiang Province, China, indicate that the predominant characteristics of PCa patients and trends in initial management are changing rapidly. We found the following: (a) a trend toward a decreased age among newly diagnosed patients; (b) a trend toward lower initial PSA levels; (c) a downward trend in risk group classification; (d) a significant increase in the likelihood of receiving RP, particularly in the high-risk group; (e) an increase in the rate of RP, mostly due to use of the Da Vinci robotic system; (f) a significant increase in the likelihood of receiving RT, especially in the low-risk group; and (g) a decrease in HT and AS&O.

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Changing Patterns of Primary Treatment in Korean Men with Prostate Cancer Over 10 Years: A Nationwide Population Based Study

Cited by 26 publications

References 24 publications

Medical Travel among Non-Seoul Residents to Seek Prostate Cancer Treatment in Medical Facilities of Seoul

Medical Travel among Non-Seoul Residents to Seek Prostate Cancer Treatment in Medical Facilities of Seoul

Risk of Ischemic Heart Disease and Stroke in Prostate Cancer Survivors: A Nationwide Study in South Korea

Trends in Treatment for Prostate Cancer in China: Preliminary Patterns of Care Study in a Single Institution

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