Current Use of Imaging after Primary Treatment of Prostate Cancer

Hussein, Ahmed A.; Punnen, Sanoj; Zhao, Shoujun; Cowan, Janet E.; Leapman, Michael; Tran, Thanh C.; Washington, Samuel L.; Truesdale, Matthew D.; Carroll, Peter R.; Cooperberg, Matthew R.

doi:10.1016/j.juro.2015.01.097

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…Based on GLOBOCAN estimates, approximately 1.3 million new cases were clinically diagnosed with PCa in 2018, leading to approximately 359,000 PCa-related deaths worldwide [1]. Several therapeutic strategies, including radical prostatectomy and radiotherapy, have shown a better clinical outcome for patients with early-stage PCa [2, 3]. In contrast, patients with advanced stage PCa have distant metastases and consequently, worse prognosis because of the lack of the effective treatment options [4, 5].…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis and The Cancer Genome Atlas data of prostate cancer risk and prognosis using epithelial cell adhesion molecule (EpCAM) expression

Gao

et al. 2019

BMC Urol

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Background: Epithelial cell adhesion molecule (EpCAM) expression has been reported in many types of cancer, including prostate cancer (PCa). However, the role of EpCAM expression remains inconsistent. We conducted a meta-analysis to assess the clinicopathological and prognostic significance of EpCAM expression in PCa. Methods: Publications were searched online using electronic databases. The available data were obtained from The Cancer Genome Atlas (TCGA). The odds ratios (ORs) or hazard ratios (HRs) with their 95% confidence intervals (CIs) were calculated. Results: We identified seven studies in which immunohistochemistry was used and that included 871 prostatic tissue samples. EpCAM expression was significantly higher in PCa samples than in benign and normal tissue samples (OR = 77.93, P = 0.002; OR = 161.61, P < 0.001; respectively). No correlation of EpCAM overexpression with pT stage and lymph node metastasis was observed; however, EpCAM overexpression showed a significant correlation with Gleason score (OR = 0.48, P = 0.012) and bone metastasis (OR = 145.80, P < 0.001). Furthermore, TCGA data showed that EpCAM overexpression was not closely correlated with age, pT stage, lymph node metastasis, number of lymph node, prostate-specific antigen level, Gleason score, biochemical recurrence, and overall survival. Based on multivariate Cox proportional-hazards regression analysis, a significant correlation was observed between EpCAM overexpression and 5-year worse biochemical recurrence free-survival. Conclusions: EpCAM overexpression may be correlated with the development of bone metastasis and worse biochemical recurrence free-survival of PCa. Further studies are needed to verify these findings.

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Section: Introductionmentioning

confidence: 99%

A meta-analysis and The Cancer Genome Atlas data of prostate cancer risk and prognosis using epithelial cell adhesion molecule (EpCAM) expression

Gao

et al. 2019

BMC Urol

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“…These findings suggest a higher rate of post‐RP bone scan use than found in prior studies and are reminiscent of imaging overuse in the pretreatment setting . While imaging overuse in the evaluation of newly diagnosed prostate cancer has been extensively studied, there is a paucity of literature investigating post‐treatment use.…”

Section: Discussionmentioning

confidence: 70%

“…We characterised adjuvant and salvage therapy rates, investigated PSA levels at the time of bone scan, and identified predictors associated with post‐RP bone scan use. A better understanding of bone scan use after prostate cancer treatment will inform high‐value use of current imaging resources, and identify considerations for emerging, expensive next‐generation imaging techniques .…”

Section: Introductionmentioning

confidence: 99%

Characterising potential bone scan overuse amongst men treated with radical prostatectomy

et al. 2018

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ObjectivesTo characterise bone scan use, and potential overuse, after radical prostatectomy (RP) using data from a large, national integrated delivery system. Overuse of imaging is well documented in the setting of newly diagnosed prostate cancer, but whether overuse persists after RP remains unknown. Patients and methodsWe identified 12 269 patients with prostate cancer treated with RP between 2005 and 2008 using the Veterans Administration Central Cancer Registry. We used administrative and laboratory data to examine rates of bone scan use, including preceding prostate-specific antigen (PSA) levels, and receipt of adjuvant or salvage therapy. We then performed multivariable logistic regression to identify factors associated with post-RP bone scan use. ResultsAt a median follow-up of 6.8 years, one in five men (22%) underwent a post-RP bone scan at a median PSA level of 0.2 ng/mL. Half of bone scans (48%) were obtained in men who did not receive further treatment with androgendeprivation or radiation therapy. After adjustment, post-RP bone scan was associated with a prior bone scan (adjusted odds ratio [aOR] 1.55, 95% confidence interval [CI] 1.32-1.84), positive surgical margin (aOR 1.68, 95% CI 1.40-2.01), preoperative PSA level (aOR 1.02, 95% CI 1.01-1.03), as well as Hispanic ethnicity, Black race, and increasing D'Amico risk category, but not with age or comorbidity. ConclusionWe found a substantial rate of bone scan utilisation after RP. The majority were performed for PSA levels of <1 ng/ mL where the likelihood of a positive test is low. More judicious use of imaging appears warranted in the post-RP setting.

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“…Each treatment modality requires consideration of various factors including age, comorbidities, and tumor characteristics in order to optimize outcomes for patients, yet factors such as employment, life responsibilities, and one's ability to take time off for cancer care remain excluded from standardized risk assessments used to inform treatment decision 5–7 . Regardless of the modality used, undergoing treatment and post‐treatment follow‐up will require that time spent at work or managing other responsibilities will now be devoted to their cancer care which may include clinic visits, lab testing, and additional imaging tests 8,9 . This work burden remains a concern for patients that may not be routinely addressed by providers and is not addressed within treatment guidelines 2–4,10 …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] Regardless of the modality used, undergoing treatment and post-treatment follow-up will require that time spent at work or managing other responsibilities will now be devoted to their cancer care which may include clinic visits, lab testing, and additional imaging tests. 8,9 This work burden remains a concern for patients that may not be routinely addressed by providers and is not addressed within treatment guidelines. [2][3][4]10 The work burden of cancer treatment is not limited to the treatment period itself; cancer surveillance after treatment routinely lasts for at least 5-10 years with the frequency of clinic visits and testing changing over time.…”

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confidence: 99%

Ten‐year work burden after prostate cancer treatment

Washington,

Lonergan,

Cowan

et al. 2023

Cancer Medicine

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IntroductionWe aim to characterize the magnitude of the work burden (weeks off from work) associated with prostate cancer (PCa) treatment over a 10‐year period after PCa diagnosis and identify those at greatest risk.Materials and MethodsWe identified men diagnosed with PCa treated with radical prostatectomy, radiation therapy, or active surveillance/watchful waiting within CaPSURE. Patients self‐reported work burden and SF36 general health scores via surveys before and 1,3,5, and 10 years after treatment. Using multivariate repeated measures generalized estimating equation modeling we examined the association between primary treatment with risk of any work weeks lost due to care.ResultsIn total, 6693 men were included. The majority were White (81%, 5% Black, and 14% Other) with CAPRA low‐ (60%) or intermediate‐risk (32%) disease and underwent surgery (62%) compared to 29% radiation and 9% active surveillance. Compared to other treatments, surgical patients were more likely to report greater than 7 days off work in the first year, with relatively less time off over time. Black men (RR 0.64, 95% CI 0.54–0.77) and those undergoing radiation (vs. surgery, RR 0.46, 95% CI 0.41–0.51) were less likely to report time off from work over time. Mean baseline GH score (73 [SD 18]) was similar between race and treatment groups, and stable over time.ConclusionsThe work burden of cancer care continued up to 10 years after treatment and varied across racial groups and primary treatment groups, highlighting the multifactorial nature of this issue and the call to leverage greater resources for those at greatest risk.

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Current Use of Imaging after Primary Treatment of Prostate Cancer

Cited by 4 publications

References 28 publications

A meta-analysis and The Cancer Genome Atlas data of prostate cancer risk and prognosis using epithelial cell adhesion molecule (EpCAM) expression

A meta-analysis and The Cancer Genome Atlas data of prostate cancer risk and prognosis using epithelial cell adhesion molecule (EpCAM) expression

Characterising potential bone scan overuse amongst men treated with radical prostatectomy

Ten‐year work burden after prostate cancer treatment

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