Patterns of prescription and adherence to European Association of Urology guidelines on androgen deprivation therapy in prostate cancer: An Italian multicentre cross-sectional analysis from the Choosing Treatment for Prostate Cancer (CHOICE) study
| Autor: | Pietro Gabriele, G Savoca, Roberto Bortolus, Arcangelo Pagliarulo, Vincenzo Ficarra, Alberto Del Nero, Umberto Ricardi, Giovanna Mantini, Sergio Serni, R. Tenaglia, Andrea Tubaro, Giancarlo Lay, Filiberto Zattoni, Giovanni Novella, Claudio Simeone, Ugo De Paula, Massimo Porena, Paola Pinnarò, Giorgio Carmignani, Giuseppe Morgia, Vincenzo Mirone, Rosario Leonardi, Maurizio Brausi, Paolo Gontero, Salvatore Siracusano, Fabio Trippa, Giorgio Ivan Russo, Giuseppe Mario Ludovico, Francesco Rocco, D.F. Randone, Giuseppe Vespasiani, Renzo Corvò, Carlo Terrone |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Time Factors Cross-sectional study medicine.medical_treatment 030232 urology & nephrology androgen deprivation therapy Settore MED/24 - Urologia Androgen deprivation therapy Prostate cancer 0302 clinical medicine European Association of Urology adherence guidelines prostate cancer Aged Aged 80 and over Androgen Antagonists Antineoplastic Agents Hormonal Combined Modality Therapy Cross-Sectional Studies Humans Italy Neoplasm Recurrence Local Patient Selection Practice Guidelines as Topic Prescriptions Prostate-Specific Antigen Prostatic Neoplasms Urology Guideline Adherence 80 and over Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA Prostatectomy Prostate-specific antigen Local 030220 oncology & carcinogenesis Cohort medicine.medical_specialty Antineoplastic Agents 03 medical and health sciences medicine Medical prescription Hormonal business.industry Neoplasm Recurrence Odds ratio adherence androgen deprivation therapy European Association of Urology guidelines prostate cancer Urology medicine.disease business |
| Popis: | Objective To evaluate both the patterns of prescription of androgen deprivation therapy (ADT) in patients with prostate cancer (PCa) and the adherence to European Association of Urology (EAU) guidelines for ADT prescription. Methods The Choosing Treatment for Prostate Cancer (CHOICE) study was an Italian multicentre cross-sectional study conducted between December 2010 and January 2012. A total of 1 386 patients, treated with ADT for PCa (first prescription or renewal of ADT), were selected. With regard to the EAU guidelines on ADT, the cohort was categorized into discordant ADT (Group A) and concordant ADT (Group B). Results The final cohort included 1 075 patients with a geographical distribution including North Italy (n = 627, 58.3%), Central Italy (n = 233, 21.7%) and South Italy (n = 215, 20.0%). In the category of patients treated with primary ADT, a total of 125 patients (56.3%) were classified as low risk according to D'Amico classification. With regard to the EAU guidelines, 285 (26.51%) and 790 patients (73.49%) were classified as discordant (Group A) and concordant (Group B), respectively. In Group A, patients were more likely to receive primary ADT (57.5%, 164/285 patients) than radical prostatectomy (RP; 30.9%, 88/285 patients), radiation therapy (RT; 6.7%, 19/285 patients) or RP + RT (17.7%, 14/285 patients; P < 0.01). Multivariate logistic regression analysis, adjusted for clinical and pathological variables, showed that patients from Central Italy (odds ratio [OR] 2.86; P < 0.05) and South Italy (OR 2.65; P < 0.05) were more likely to receive discordant ADT. Conclusion EAU guideline adherence for ADT was low in Italy and was influenced by geographic area. Healthcare providers and urologists should consider these results in order to quantify the inadequate use of ADT and to set policy strategies to overcome this risk. |
| Databáze: | OpenAIRE |
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