Decipher test impacts decision making among patients considering adjuvant and salvage treatment after radical prostatectomy: Interim results from the Multicenter Prospective PRO-IMPACT study
| Autor: | Fernando J. Bianco, Edouard J. Trabulsi, David Y.T. Chen, Paul Maroni, Marguerite du Plessis, Kasra Yousefi, John L. Gore, Darby J. S. Thompson, Mark Bandyk, Brian R. Lane, Robert J. Waterhouse, Michael E. Franks, William Clark, Paul Sieber, William T. Lowrance, Hyung L. Kim, Scott Perrapato, Lawrence Karsh, Gordon D. Brown, Elai Davicioni, Daniel W. Lin, Adam S. Kibel, Maria Santiago-Jimenez, Yair Lotan, Murugesan Manoharan |
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| Rok vydání: | 2017 |
| Předmět: |
Cancer Research
medicine.medical_specialty Prostatectomy business.industry medicine.medical_treatment 030232 urology & nephrology Salvage therapy Odds ratio Confidence interval 03 medical and health sciences 0302 clinical medicine Oncology Quality of life 030220 oncology & carcinogenesis Internal medicine medicine Adjuvant therapy Physical therapy DECIPHER Prospective cohort study business |
| Zdroj: | Cancer. 123:2850-2859 |
| ISSN: | 0008-543X |
| Popis: | BACKGROUND Patients with prostate cancer and their providers face uncertainty as they consider adjuvant radiotherapy (ART) or salvage radiotherapy (SRT) after undergoing radical prostatectomy. The authors prospectively evaluated the impact of the Decipher test, which predicts metastasis risk after radical prostatectomy, on decision making for ART and SRT. METHODS A total of 150 patients who were considering ART and 115 who were considering SRT were enrolled. Providers submitted a management recommendation before processing the Decipher test and again at the time of receipt of the test results. Patients completed validated surveys on prostate cancer (PCa)-specific decisional effectiveness and PCa-related anxiety. RESULTS Before the Decipher test, observation was recommended for 89% of patients considering ART and 58% of patients considering SRT. After Decipher testing, 18% (95% confidence interval [95% CI], 12%-25%) of treatment recommendations changed in the ART arm, including 31% among high-risk patients; and 32% (95% CI, 24%-42%) of management recommendations changed in the salvage arm, including 56% among high-risk patients. Decisional Conflict Scale (DCS) scores were better after viewing Decipher test results (ART arm: median DCS before Decipher, 25 and after Decipher, 19 [P |
| Databáze: | OpenAIRE |
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