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(S045) Specialty Biases Influence Recommended Treatment Strategies for Patients With High-Risk Prostate Cancer: A Patterns-of-Care Study

April 15, 2016
Publication
Article
OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1
Conference|Annual Meeting of the American Radium Society (ARS)

Specialty-specific differences were identified for both upfront management and management after biochemical recurrences for high-risk prostate cancer, with specialists more likely to recommend the treatments they could deliver for nearly all clinical scenarios, whether these recommendations were based on high-level evidence or not.

Amar U. Kishan, MD, Gillian Duchesne, MD, Pin-Chieh Wang, PhD, Jean-Claude Rwigema, MD, Matthew Rettig, MD, Christopher Saigal, MD, Michael L. Steinberg, MD, Christopher R. King, MD, PhD; UCLA; University of Melbourne

BACKGROUND: The optimal management of high-risk prostate cancer (CaP) remains controversial. We hypothesized that specialty-specific differences would manifest in treatment recommendations between radiation oncologists and urologists, regardless of the level of evidence supporting various strategies.

METHODS: An online survey was offered to radiation oncologists and urologists, querying opinions about treating high-risk CaP in the upfront setting, postoperatively, or after biochemical recurrences (BCRs) following radiation therapy (RT). Multivariate logistic regression was used to analyze how specialty influenced responses, adjusted for practice setting, training level, percentage of consultation caseload consisting of CaP, and nationality.

RESULTS: A total of 1,253 physicians (846 radiation oncologists and 407 urologists) completed the survey. Radiation oncologists were more likely to prefer adjuvant RT, feel that it is underutilized, and recommend salvage RT at lower PSA thresholds (P < .0001). Urologists were more likely to recommend salvage radical prostatectomy (RP) or cryoablation for local salvage after RT, while radiation oncologists were more likely to recommend RT-based modalities and feel that local salvage was underutilized after RT (P < .0001). Urologists were more likely to feel that upfront RP was a better definitive treatment (P < .0001), while radiation oncologists were more likely to have the opposite opinion (P = .005).

CONCLUSIONS: Specialty-specific differences were identified for both upfront management and management after BCRs for high-risk CaP, with specialists more likely to recommend the treatments they could deliver for nearly all clinical scenarios, whether these recommendations were based on high-level evidence or not. These differences highlight the need for multidisciplinary clinics and improved cross-specialty education.

Proceedings of the 98th Annual Meeting of the American Radium Society -americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer

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