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Adherence to guidel...
Adherence to guidelines for androgen deprivation therapy after radical prostatectomy : Swedish population-based study
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- Lycken, Magdalena (author)
- Uppsala universitet,Urologkirurgi
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- Drevin, Linda (author)
- Regional Cancer Centre Uppsala Örebro Region, Uppsala, Sweden,Reg Canc Ctr Uppsala Örebro Reg, Uppsala, Sweden
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- Garmo, Hans (author)
- Regional Cancer Centre Uppsala Örebro Region, Uppsala, Sweden; King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), London, UK,Reg Canc Ctr Uppsala Örebro Reg, Uppsala, Sweden; Kings Coll London, Sch Canc & Pharmaceut Sci, Translat Oncol & Urol Res TOUR, London, England
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- Larsson, Anders (author)
- Uppsala universitet,Klinisk kemi
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- Andrén, Ove, 1963- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Örebro Univ, Sch Med Sci, Örebro, Sweden
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- Holmberg, Lars (author)
- Uppsala universitet,Endokrinkirurgi
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- Bill-Axelson, Anna (author)
- Uppsala universitet,Urologkirurgi
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(creator_code:org_t)
- 2020-04-27
- 2020
- English.
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In: Scandinavian journal of urology. - : Informa Healthcare. - 2168-1805 .- 2168-1813. ; 54:3, s. 208-214
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Abstract
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- Background: Androgen deprivation therapy (ADT) is a non-curative but essential treatment of prostate cancer with severe side effects. Therefore, both over- and underuse should be avoided. We investigated adherence to guidelines for ADT following radical prostatectomy through Swedish population-based data.Material and methods: We used the database Uppsala/Örebro PSA cohort (UPSAC) to study men with localised or locally advanced prostate cancer at diagnosis (clinical stage T1-T3, N0-NX, M0-MX, and prostate-specific antigen (PSA) <50 ng/ml) who underwent radical prostatectomy 1997-2012. 114 men were treated with ADT and selected as cases; 1140 men with no ADT at the index date were selected as controls within 4-year strata of year of radical prostatectomy. All men with a biochemical recurrence and a PSA doubling time <12 months and/or a Gleason score of 8-10 were considered to have an indication for ADT according to the European Association of Urology (EAU) guidelines.Results: No indication for ADT was found in 37% of the cases. Among these, 88% had clinical stage T1-2 at diagnosis, 57% had a biopsy Gleason score 2-6, 98% had an expected remaining lifetime over 10 years, 12% received castration, and 88% received antiandrogen monotherapy. 2% of controls were found to have an indication for ADT, and 96% of these had an expected remaining lifetime over 10 years.Conclusion: Our results indicate that overtreatment with ADT after radical prostatectomy is common, whereas undertreatment is unusual. Interventions to improve adherence to guidelines are needed to avoid unnecessary side-effects and long treatment durations with ADT.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- Androgen deprivation therapy
- guidelines
- population-based study
- prostate cancer
- radical prostatectomy
Publication and Content Type
- ref (subject category)
- art (subject category)
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