Variation in the Prescription of Androgen Deprivation Therapy in Intermediate- and High-risk Prostate Cancer Patients Treated with Radiotherapy in the Netherlands, and Adherence to European Association of Urology Guidelines: A Population-based Study

Rijksen, Barbara Lily Thérèse; Pos, Floris J.; Hulshof, Maarten C.C.M.; Vernooij, Robin W.M.; Jansen, Hanneke; Andel, George van; Wijsman, Bart P.; Somford, D.M.; Busstra, Martijn B.; Moorselaar, R. Jeroen A. van; Kaa, Christina A. Hulsbergen‐van de; Leenders, Geert J.L.H. van; Hamberg, Paul; Berkmortel, Franchette van den; Fütterer, Jurgen J.; Kiemeney, Lambertus A.; Oort, Inge M. van; Aben, Katja K.H.

doi:10.1016/j.euf.2019.11.005

Cited by 9 publications

(8 citation statements)

References 17 publications

(19 reference statements)

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“…In our study, however, only approximately one quarter of the surgically untreated HRLPCa cases received guideline-recommended treatment. This finding was far below those reported in studies in the U.S.A. [ 22 , 39 – 41 ] and in the Netherlands [ 42 ]. Contrary to our study, data from German Prostate Cancer Centers found high guideline-adherence (85.4% in 2017) in terms of delivering RT with HT for locally advanced (T 3-4 N 0 M 0 ) PCa cases [ 43 ].…”

Section: Discussioncontrasting

confidence: 72%

“…If this holds true, we could suppose that occurrence of comorbidities might have contributed for the decreased uptake of HT in the HRLPCa cases. While some studies on the association of comorbidity and HT use showed conflicting results [ 23 , 42 , 46 ], absence of comorbidity data in this study makes the interpretation of our results difficult. Wang et al found a decrease in the duration of HT was certainly related to comorbidities, but it was mentioned that the degree of HT underutilization was not fully explained by comorbidities alone [ 40 ].…”

Section: Discussioncontrasting

confidence: 58%

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Suboptimal use of hormonal therapy among German men with localized high-risk prostate Cancer during 2005 to 2015: analysis of registry data

et al. 2022

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Background This study assesses the use of hormonal therapy to treat high-risk localized prostate cancer (HRLPCa) cases diagnosed between 2005 and 2015. Methods All N0-XM0 with ≥T3a, or PCa cases with poorly differentiated feature (equivalent to Gleason score ≥ 8), diagnosed between 2005 and 2015 were extracted from German population-based cancer registries. Cases treated by surgery or chemotherapy were excluded. Description of hormonal therapy use by HRLPCa cases’ profile was presented. Relative risk (RR) was computed with a log-link function to identify factors associated with hormonal therapy use among radiotherapy-treated HRLPCa cases. Results A total of 5361 HRLPCa cases were analyzed. Only 27.6% (95% confidence interval [CI]: 26.4–28.8%) of the HRLPCa cases received hormonal therapy in combination with radiotherapy. The use of combined hormonal therapy and radiotherapy varied from 19.8% in Saxony to 47.8% in Schleswig-Holstein. Application of hormonal therapy was higher for the locally advanced cases compared to the poorly differentiated cases (relative risk [RR] = 1.28; 95%CI: 1.19, 1.37). Older patients showed a slightly increased use of hormonal therapy (RR for a 10-year age increase = 1.09; 95%CI: 1.02, 1.16). Compared to PCa cases from the most affluent residential areas, cases from the least affluent (RR = 0.71; 95%CI: 0.55, 0.92) and medium (RR = 0.75; 95%CI: 0.58, 0.96) areas had decreased use of hormonal therapy. The introduction of the German S3-guideline did not make a marked difference in the uptake of both hormonal therapy and radiotherapy (RR = 1.02; 95%CI: 0.95, 1.09). Conclusion This study found a low use of hormonal therapy among HRLPCa patients treated without surgery. The introduction of the German S3-guideline for prostate cancer treatment does not seem to have impacted hormonal therapy use.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussioncontrasting

confidence: 58%

Suboptimal use of hormonal therapy among German men with localized high-risk prostate Cancer during 2005 to 2015: analysis of registry data

et al. 2022

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“…To date, the use of NHT prior to RP has been explored in multiple studies. The current European Association of Urology guidelines recommend the use of NHT only for patients with intermediate or high-risk PCa if they receive radiation therapy ( 10 ). However, due to the lack of solid evidence in survival benefit, the current international guidelines lack clear recommendations for the use of NHT before RP.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Neoadjuvant Hormone Therapy on Surgical and Oncological Outcomes for Patients With Prostate Cancer Before Radical Prostatectomy: A Systematic Review and Meta-Analysis

Zhang

Zhao

et al. 2021

Front. Oncol.

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ObjectiveThis systematic study aimed to assess and compare the comprehensive evidence regarding the impact of neoadjuvant hormone therapy (NHT) on surgical and oncological outcomes of patients with prostate cancer (PCa) before radical prostatectomy (RP).MethodsLiterature searches were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Using PubMed, Web of Science, Chinese National Knowledge Infrastructure, and Wanfang databases, we identified relevant studies published before July 2020. The pooled effect sizes were calculated in terms of the odds ratios (ORs)/standard mean differences (SMDs) with 95% confidence intervals (CIs) using the fixed or random-effects model.ResultsWe identified 22 clinical trials (6 randomized and 16 cohort) including 20,199 patients with PCa. Our meta-analysis showed no significant differences in body mass index (SMD = 0.10, 95% CI: −0.08–0.29, p = 0.274) and biopsy Gleason score (GS) (OR = 1.33, 95% CI: 0.76–2.35 p = 0.321) between the two groups. However, the NHT group had a higher mean age (SMD = 0.19, 95% CI: 0.07–0.31, p = 0.001), preoperative prostate-specific antigen (OR = 0.47, 95% CI: 0.19–0.75, p = 0.001), and clinic tumor stage (OR = 2.24, 95% CI: 1.53–3.29, p < 0.001). Compared to the RP group, the NHT group had lower positive surgical margins (PSMs) rate (OR = 0.44, 95% CI: 0.29–0.67, p < 0.001) and biochemical recurrence (BCR) rate (OR = 0.47, 95% CI: 0.26–0.83, p = 0.009). Between both groups, there were no significant differences in estimated blood loss (SMD = −0.06, 95% CI: −0.24–0.13, p = 0.556), operation time (SMD = 0.20, 95% CI: −0.12–0.51, p = 0.219), pathological tumor stage (OR = 0.76, 95% CI: 0.54–1.06, p = 0.104), specimen GS (OR = 0.91, 95% CI: 0.49–1.68, p = 0.756), and lymph node involvement (OR = 0.76, 95% CI: 0.40–1.45, p = 0.404).ConclusionsNHT prior to RP appeared to reduce the tumor stage, PSMs rate, and risk of BCR in patients with PCa. According to our data, NHT may be more suitable for older patients with higher tumor stage. Besides, NHT may not increase the surgical difficulty of RP.

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“…Ook zijn onderliggende factoren en mogelijke verbeterpunten geïdentificeerd. De belangrijkste resultaten van ProZIB zijn in diverse artikelen gepubliceerd [3][4][5]. Daarnaast is een rapport met bevindingen en aanbevelingen aangeboden aan alle betrokken wetenschappelijke verenigingen.…”

Section: Artikelunclassified

Kwaliteitsregistratie prostaatcarcinoom: ziekenhuisregistratie versus Nederlandse Kankerregistratie

et al. 2021

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SamenvattingGoede kwaliteitsregistraties zijn cruciaal, omdat zij inzicht verschaffen in de kwaliteit van geleverde zorg en mogelijke verbeterpunten. De NVU is in 2008 gestart met de kwaliteitsregistratie prostaatcarcinoom waarin data zijn vastgelegd door zorgprofessionals. Sinds 1989 bestaat ook de landelijk dekkende Nederlandse Kankerregistratie (NKR) waarin data over prostaatkanker worden vastgelegd door datamanagers van Integraal Kankercentrum Nederland (IKNL), die hiertoe medische dossiers raadplegen. In 2015 is IKNL samen met de NVU en andere wetenschappelijke verenigingen gestart met ProZIB, ‘ProstaatkankerZorg In Beeld’. Op basis van ProZIB-resultaten is de NKR-Prostaatkankerset uitgebreid en daarmee geschikt geworden voor continue kwaliteitsmonitoring. Als onderdeel van ProZIB is de NVU-Kwaliteitsregistratie Prostaatcarcinoom vergeleken met de NKR wat betreft compleetheid en inhoud. De NKR bleek completer wat betreft het aantal radicale prostatectomieën (94% versus 62–85%). Inhoudelijk kwamen de registraties grotendeels overeen. Voordelen van een kwaliteitsregistratie in de NKR zijn: onafhankelijkheid, uniformiteit en verminderde registratielast voor de zorgprofessional bij gelijkblijvende inhoudelijke kwaliteit.

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Variation in the Prescription of Androgen Deprivation Therapy in Intermediate- and High-risk Prostate Cancer Patients Treated with Radiotherapy in the Netherlands, and Adherence to European Association of Urology Guidelines: A Population-based Study

Cited by 9 publications

References 17 publications

Suboptimal use of hormonal therapy among German men with localized high-risk prostate Cancer during 2005 to 2015: analysis of registry data

Suboptimal use of hormonal therapy among German men with localized high-risk prostate Cancer during 2005 to 2015: analysis of registry data

The Impact of Neoadjuvant Hormone Therapy on Surgical and Oncological Outcomes for Patients With Prostate Cancer Before Radical Prostatectomy: A Systematic Review and Meta-Analysis

Kwaliteitsregistratie prostaatcarcinoom: ziekenhuisregistratie versus Nederlandse Kankerregistratie

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