Evidence map›Paper›PMID 34516660›Full record

ArticleCancer2022

Treatment in the absence of disease reclassification among men on active surveillance for prostate cancer.

Peter S Kirk, Kehao Zhu, Yingye Zheng, Lisa F Newcomb, Jeannette M Schenk, James D Brooks, Peter R Carroll, Atreya Dash, William J Ellis, Christopher P Filson and 10 more

Abstract read
In one paragraph

Article in Cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. A Pilot Study ofThe Prostate · 2026
    Article
  2. Review
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors.

Peter S KirkDepartment of Urology, University of Washington, Seattle, Washington.ORCID 0000-0002-1616-4478
Kehao ZhuBiostatistics Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Yingye ZhengBiostatistics Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Lisa F NewcombDepartment of Urology, University of Washington, Seattle, Washington.
Jeannette M SchenkCancer Prevention Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
James D BrooksDepartment of Urology, Stanford University, Stanford, California.
Peter R CarrollDepartment of Urology, University of California, San Francisco, California.
Atreya DashVA Puget Sound Health Care Systems, Seattle, Washington.
William J EllisDepartment of Urology, University of Washington, Seattle, Washington.
Christopher P FilsonDepartment of Urology, Emory University, Atlanta, Georgia.ORCID 0000-0002-8184-7275
Martin E GleaveDepartment of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Michael LissDepartment of Urology, University of Texas Health Sciences Center, San Antonio, Texas.
Frances MartinDepartment of Urology, Eastern Virginia Medical School, Virginia Beach, Virginia.
Jesse K McKenneyRobert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
Todd M MorganDepartment of Urology, University of Michigan, Ann Arbor, Michigan.
Peter S NelsonDivision of Human Biology and Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Ian M ThompsonCHRISTUS Medical Center Hospital, San Antonio, Texas.ORCID 0000-0003-0833-952X
Andrew A WagnerDivision of Urology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Daniel W LinDepartment of Urology, University of Washington, Seattle, Washington.
John L GoreDepartment of Urology, University of Washington, Seattle, Washington.

Funding

TRANSCRIPTOME AND PROTEOME STRATIFICATION OF PROSTATE ADENOCARCINOMA PHENOTYPESP50CA097186 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI PETER S NELSON · 2002 to 2026
$58.1M
Prostate cancer Active Surveillance Study (PASS) Cohort: Infrastructure Support for Cancer ResearchU01CA224255 · NCI · FRED HUTCHINSON CANCER RESEARCH CENTER · PI LIN, DANIEL W. · 2019 to 2023
$6.7M
NCI NIH HHS P50 CA097186NCI NIH HHS U01 CA224255
6 · The paper itself

Abstract

backgroundMaintaining men on active surveillance for prostate cancer can be challenging. Although most men who eventually undergo treatment have experienced clinical progression, a smaller subset elects treatment in the absence of disease reclassification. This study sought to understand factors associated with treatment in a large, contemporary, prospective cohort.

methodsThis study identified 1789 men in the Canary Prostate Cancer Active Surveillance Study cohort enrolled as of 2020 with a median follow-up of 5.6 years. Clinical and demographic data as well as information on patient-reported quality of life and urinary symptoms were used in multivariable Cox proportional hazards regression models to identify factors associated with the time to treatment

resultsWithin 4 years of their diagnosis, 33% of men (95% confidence interval [CI], 30%-35%) underwent treatment, and 10% (95% CI, 9%-12%) were treated in the absence of reclassification. The most significant factor associated with any treatment was an increasing Gleason grade group (adjusted hazard ratio [aHR], 14.5; 95% CI, 11.7-17.9). Urinary quality-of-life scores were associated with treatment without reclassification (aHR comparing "mostly dissatisfied/terrible" with "pleased/mixed," 2.65; 95% CI, 1.54-4.59). In a subset analysis (n = 692), married men, compared with single men, were more likely to undergo treatment in the absence of reclassification (aHR, 2.63; 95% CI, 1.04-6.66).

conclusionsA substantial number of men with prostate cancer undergo treatment in the absence of clinical changes in their cancers, and quality-of-life changes and marital status may be important factors in these decisions. LAY SUMMARY: This analysis of men on active surveillance for prostate cancer shows that approximately 1 in 10 men will decide to be treated within 4 years of their diagnosis even if their cancer is stable. These choices may be related in part to quality-or-life or spousal concerns.

Indexed as

Prostatic NeoplasmsWatchful WaitingHumansMaleNeoplasm GradingProspective StudiesProstate-Specific AntigenQuality of LifeProstate-Specific Antigenactive surveillanceprostatic neoplasmsquality of life

Identifiers

PMID34516660
PMCPMC8738121

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.