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Title 640 Current trends in management of high-risk prostate cancer in Europe: Results of a web-based survey by the Prostate Cancer Working Group of the Young Academic Urologists Working Party of the European Association of Urology
Source European Supplements, 13 ,1
Year 2014
Database ScienceDirect
Access date 28.01.2015

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INTRODUCTION & OBJECTIVES: High-risk prostate cancer (PCa) accounts for up to 40% of newly diagnosed cases. Disease recurrence remains substantial, affecting >50% of patients within 10 years after treatment. In the absence of high-level evidence, definition, clinical staging and therapy remain controversial. Physicians’ preferences and local medical infrastructure availability may lead to substantial variations in the management of such patients. In this study, we explored the current trends in diagnosis and management of patients with newly diagnosed high-risk PCa in Europe.
MATERIAL & METHODS: A web-based survey was conducted in August 2013 by members of the Prostate Cancer Working Group of the Young Academic Urologists (YAU) Working Party of the European Association of Urology (EAU). A specific questionnaire was sent by email to xx physicians who were included in the mailing-list of the EAU members. Participants were invited to answer a multiple-choice questionnaire including 25-items covering the whole spectrum of diagnosis, staging and treatment of high-risk PCa. Europe was divided into three geographical regions: North-Western (NW), Central-Eastern (CE) and Southern (S). Data collection and processing was performed in accordance with the ICC/ESOMAR Code on Market and Social Research. Statistical analysis was performed by GfK.
RESULTS: Of the 9,829 invited EAU-members practicing in Europe, 585 (6%) completed the survey. Most of them work in an academic setting and have an institutional multidisciplinary team involved in PCa management. High-risk PCa is defined as serum PSA ≥20 ng/ml or clinical stage≥T3 or biopsy Gleason score≥8 by 67% of responders with no geographical variations. Preferred single imaging exam for clinical staging are bone scan (74%), MRI (53%, 72% in NW) and CT (45%, 60% in S). Partin tables and D’Amico risk classification are used by 62% of the physicians on a routine basis. Preferred treatment is radical prostatectomy as part of multimodal treatment (60%, 40% in NW and 70% in CE), followed by external beam radiation therapy with androgen deprivation therapy (29%, 45% in NW and 20% in CE). There is ample heterogeneity in the definition of disease recurrence after primary treatment and use of adjuvant and salvage treatments, even within the same geographical region.
CONCLUSIONS: The present study is the first international survey evaluating patterns of diagnosis and treatment of high-risk PCa in Europe. Although definition of high-risk PCa is uniform across European countries, wide variations in clinical staging and treatment patterns were observed. These differences might translate into variations in quality of care with a possible impact on ultimate oncological outcome.

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Year of publication2014
Bibliographic typeJournal article
Full text availabilityAvailable on request
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