Prostate Cancer AS Loss to Follow-Up Risk at 2 Years Estimated at 10%

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The risk being lost to follow-up while on active surveillance for prostate cancer is higher among blacks than whites, according to a study.
The risk being lost to follow-up while on active surveillance for prostate cancer is higher among blacks than whites, according to a study.

An estimated 10% of men placed on active surveillance (AS) for prostate cancer will be lost to follow-up (LTFU) at the 2-year time point, according to a new study.

The likelihood of being LTFU is higher among black patients and those who are generally unhealthy, results showed.

“Patients who are LTFU, theoretically, may have worse outcomes due to insufficient monitoring and missed opportunities to convert to definitive therapy,” Kevin B. Ginsburg, MD, of Wayne State University School of Medicine in Detroit, and colleagues reported online ahead of print in European Urology.

Findings from their study reveal opportunities to identify systems of care to decrease the number of LTFU events, thus improving the quality and long-term safety of AS for men with early-stage prostate cancer, they concluded.

Using a prospective registry maintained by the Michigan Urologic Surgery Improvement Collaborative (MUSIC), Dr Ginsburg's team identified 2211 men managed with AS from 2011 to 2017. After a median surveillance period of 32 months, the estimated LTFU-free probability was 90%. Compared with white patients, black patients had a significant 2.8-fold increased risk of being LTFU. In addition, compared with patients with a Charlson comorbidity index (CCI) of 0, those with a CCI of 1 or more had a significant 55% increased risk of being LTFU.

“It is important to note that patients of all races, ages, and CCI are at risk for LTFU,” the authors wrote. “Our data do not imply that certain patients should be excluded from AS. However, the data may help identify patients that are at higher risk for becoming LTFU.”

Reference

Ginsburg KB, Auffenberg GB, Qi J, et al. Risk of becoming lost to follow-up during active surveillance for prostate cancer. Eur Urol. 2018; published online ahead of print.

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