Reasons for Discontinuing Active Surveillance: Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium

Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium, Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Careful assessment of the reasons for discontinuation of active surveillance (AS) is required for men with prostate cancer (PCa). Objective: Using Movember's Global Action Plan Prostate Cancer Active Surveillance initiative (GAP3) database, we report on reasons for AS discontinuation. Design, setting, and participants: We compared data from 10 296 men on AS from 21 centres across 12 countries. Outcome measurements and statistical analysis: Cumulative incidence methods were used to estimate the cumulative incidence rates of AS discontinuation. Results and limitations: During 5-yr follow-up, 27.5% (95% confidence interval [CI]: 26.4–28.6%) men showed signs of disease progression, 12.8% (95% CI: 12.0–13.6%) converted to active treatment without evidence of progression, 1.7% (95% CI: 1.5–2.0%) continued to watchful waiting, and 1.7% (95% CI: 1.4–2.1%) died from other causes. Of the 7049 men who remained on AS, 2339 had follow-up for >5 yr, 4561 had follow-up for <5 yr, and 149 were lost to follow-up. Cumulative incidence of progression was 27.5% (95% CI: 26.4–28.6%) at 5 yr and 38.2% (95% CI: 36.7–39.9%) at 10 yr. A limitation is that not all centres were included due to limited information on the reason for discontinuation and limited follow-up. Conclusions: Our descriptive analyses of current AS practices worldwide showed that 43.6% of men drop out of AS during 5-yr follow-up, mainly due to signs of disease progression. Improvements in selection tools for AS are thus needed to correctly allocate men with PCa to AS, which will also reduce discontinuation due to conversion to active treatment without evidence of disease progression. Patient summary: Our assessment of a worldwide database of men with prostate cancer (PCa) on active surveillance (AS) shows that 43.6% drop out of AS within 5 yr, mainly due to signs of disease progression. Better tools are needed to select and monitor men with PCa as part of AS.

Original languageEnglish
Pages (from-to)523-531
Number of pages9
JournalEuropean Urology
Volume75
Issue number3
DOIs
Publication statusPublished - 2019 Mar 1

Fingerprint

Confidence Intervals
Prostatic Neoplasms
Disease Progression
Incidence
Databases
Watchful Waiting
Lost to Follow-Up
Therapeutics

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium, & Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium (2019). Reasons for Discontinuing Active Surveillance: Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium. European Urology, 75(3), 523-531. https://doi.org/10.1016/j.eururo.2018.10.025
Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium ; Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium. / Reasons for Discontinuing Active Surveillance : Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium. In: European Urology. 2019 ; Vol. 75, No. 3. pp. 523-531.
@article{741964b7c8d647f1b105ca2be71b2993,
title = "Reasons for Discontinuing Active Surveillance: Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium",
abstract = "Background: Careful assessment of the reasons for discontinuation of active surveillance (AS) is required for men with prostate cancer (PCa). Objective: Using Movember's Global Action Plan Prostate Cancer Active Surveillance initiative (GAP3) database, we report on reasons for AS discontinuation. Design, setting, and participants: We compared data from 10 296 men on AS from 21 centres across 12 countries. Outcome measurements and statistical analysis: Cumulative incidence methods were used to estimate the cumulative incidence rates of AS discontinuation. Results and limitations: During 5-yr follow-up, 27.5{\%} (95{\%} confidence interval [CI]: 26.4–28.6{\%}) men showed signs of disease progression, 12.8{\%} (95{\%} CI: 12.0–13.6{\%}) converted to active treatment without evidence of progression, 1.7{\%} (95{\%} CI: 1.5–2.0{\%}) continued to watchful waiting, and 1.7{\%} (95{\%} CI: 1.4–2.1{\%}) died from other causes. Of the 7049 men who remained on AS, 2339 had follow-up for >5 yr, 4561 had follow-up for <5 yr, and 149 were lost to follow-up. Cumulative incidence of progression was 27.5{\%} (95{\%} CI: 26.4–28.6{\%}) at 5 yr and 38.2{\%} (95{\%} CI: 36.7–39.9{\%}) at 10 yr. A limitation is that not all centres were included due to limited information on the reason for discontinuation and limited follow-up. Conclusions: Our descriptive analyses of current AS practices worldwide showed that 43.6{\%} of men drop out of AS during 5-yr follow-up, mainly due to signs of disease progression. Improvements in selection tools for AS are thus needed to correctly allocate men with PCa to AS, which will also reduce discontinuation due to conversion to active treatment without evidence of disease progression. Patient summary: Our assessment of a worldwide database of men with prostate cancer (PCa) on active surveillance (AS) shows that 43.6{\%} drop out of AS within 5 yr, mainly due to signs of disease progression. Better tools are needed to select and monitor men with PCa as part of AS.",
author = "{Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium} and {Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium} and {Van Hemelrijck}, Mieke and Xi Ji and Kattan, {Mike W.} and Jozien Helleman and Roobol, {Monique J.} and Daan Nieboer and Bangma, {Chris H.} and {van der Linden}, Wim and Mark Frydenberg and Antti Rannikko and Lee, {Lui S.} and Gnanapragasam, {Vincent J.} and Bruce Trock and Behfar Ehdaie and Peter Carroll and Christopher Filson and Jeri Kim and Christopher Logothetis and Todd Morgan and Laurence Klotz and Tom Pickles and Eric Hyndman and Moore, {Caroline M.} and Prokar Dasgupta and Arnauld Villers and Riccardo Valdagni and Antoinette Perry and Jonas Hugosson and Jose Rubio-Briones and Anders Bjartell and Lukas Hefermehl and {Lui Shiong}, Lee and Yoshiyuki Kakehi and Byungha Chung and {van der Kwast}, Theo and Henk Obbink and Tim Hulsen and {de Jonge}, Cees and Ji Xinge and Kenneth Muir and Artitaya Lophatananon and Michael Fahey and Ewout Steyerberg and Liying Zhang and {Santa Olalla}, Aida and Kerri Beckmann and Brian Denton and Andrew Hayen and Paul Boutros and Wei Guo",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.eururo.2018.10.025",
language = "English",
volume = "75",
pages = "523--531",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "3",

}

Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium & Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium 2019, 'Reasons for Discontinuing Active Surveillance: Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium', European Urology, vol. 75, no. 3, pp. 523-531. https://doi.org/10.1016/j.eururo.2018.10.025

Reasons for Discontinuing Active Surveillance : Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium. / Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium; Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium.

In: European Urology, Vol. 75, No. 3, 01.03.2019, p. 523-531.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Reasons for Discontinuing Active Surveillance

T2 - Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium

AU - Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium

AU - Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium

AU - Van Hemelrijck, Mieke

AU - Ji, Xi

AU - Kattan, Mike W.

AU - Helleman, Jozien

AU - Roobol, Monique J.

AU - Nieboer, Daan

AU - Bangma, Chris H.

AU - van der Linden, Wim

AU - Frydenberg, Mark

AU - Rannikko, Antti

AU - Lee, Lui S.

AU - Gnanapragasam, Vincent J.

AU - Trock, Bruce

AU - Ehdaie, Behfar

AU - Carroll, Peter

AU - Filson, Christopher

AU - Kim, Jeri

AU - Logothetis, Christopher

AU - Morgan, Todd

AU - Klotz, Laurence

AU - Pickles, Tom

AU - Hyndman, Eric

AU - Moore, Caroline M.

AU - Dasgupta, Prokar

AU - Villers, Arnauld

AU - Valdagni, Riccardo

AU - Perry, Antoinette

AU - Hugosson, Jonas

AU - Rubio-Briones, Jose

AU - Bjartell, Anders

AU - Hefermehl, Lukas

AU - Lui Shiong, Lee

AU - Kakehi, Yoshiyuki

AU - Chung, Byungha

AU - van der Kwast, Theo

AU - Obbink, Henk

AU - Hulsen, Tim

AU - de Jonge, Cees

AU - Xinge, Ji

AU - Muir, Kenneth

AU - Lophatananon, Artitaya

AU - Fahey, Michael

AU - Steyerberg, Ewout

AU - Zhang, Liying

AU - Santa Olalla, Aida

AU - Beckmann, Kerri

AU - Denton, Brian

AU - Hayen, Andrew

AU - Boutros, Paul

AU - Guo, Wei

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: Careful assessment of the reasons for discontinuation of active surveillance (AS) is required for men with prostate cancer (PCa). Objective: Using Movember's Global Action Plan Prostate Cancer Active Surveillance initiative (GAP3) database, we report on reasons for AS discontinuation. Design, setting, and participants: We compared data from 10 296 men on AS from 21 centres across 12 countries. Outcome measurements and statistical analysis: Cumulative incidence methods were used to estimate the cumulative incidence rates of AS discontinuation. Results and limitations: During 5-yr follow-up, 27.5% (95% confidence interval [CI]: 26.4–28.6%) men showed signs of disease progression, 12.8% (95% CI: 12.0–13.6%) converted to active treatment without evidence of progression, 1.7% (95% CI: 1.5–2.0%) continued to watchful waiting, and 1.7% (95% CI: 1.4–2.1%) died from other causes. Of the 7049 men who remained on AS, 2339 had follow-up for >5 yr, 4561 had follow-up for <5 yr, and 149 were lost to follow-up. Cumulative incidence of progression was 27.5% (95% CI: 26.4–28.6%) at 5 yr and 38.2% (95% CI: 36.7–39.9%) at 10 yr. A limitation is that not all centres were included due to limited information on the reason for discontinuation and limited follow-up. Conclusions: Our descriptive analyses of current AS practices worldwide showed that 43.6% of men drop out of AS during 5-yr follow-up, mainly due to signs of disease progression. Improvements in selection tools for AS are thus needed to correctly allocate men with PCa to AS, which will also reduce discontinuation due to conversion to active treatment without evidence of disease progression. Patient summary: Our assessment of a worldwide database of men with prostate cancer (PCa) on active surveillance (AS) shows that 43.6% drop out of AS within 5 yr, mainly due to signs of disease progression. Better tools are needed to select and monitor men with PCa as part of AS.

AB - Background: Careful assessment of the reasons for discontinuation of active surveillance (AS) is required for men with prostate cancer (PCa). Objective: Using Movember's Global Action Plan Prostate Cancer Active Surveillance initiative (GAP3) database, we report on reasons for AS discontinuation. Design, setting, and participants: We compared data from 10 296 men on AS from 21 centres across 12 countries. Outcome measurements and statistical analysis: Cumulative incidence methods were used to estimate the cumulative incidence rates of AS discontinuation. Results and limitations: During 5-yr follow-up, 27.5% (95% confidence interval [CI]: 26.4–28.6%) men showed signs of disease progression, 12.8% (95% CI: 12.0–13.6%) converted to active treatment without evidence of progression, 1.7% (95% CI: 1.5–2.0%) continued to watchful waiting, and 1.7% (95% CI: 1.4–2.1%) died from other causes. Of the 7049 men who remained on AS, 2339 had follow-up for >5 yr, 4561 had follow-up for <5 yr, and 149 were lost to follow-up. Cumulative incidence of progression was 27.5% (95% CI: 26.4–28.6%) at 5 yr and 38.2% (95% CI: 36.7–39.9%) at 10 yr. A limitation is that not all centres were included due to limited information on the reason for discontinuation and limited follow-up. Conclusions: Our descriptive analyses of current AS practices worldwide showed that 43.6% of men drop out of AS during 5-yr follow-up, mainly due to signs of disease progression. Improvements in selection tools for AS are thus needed to correctly allocate men with PCa to AS, which will also reduce discontinuation due to conversion to active treatment without evidence of disease progression. Patient summary: Our assessment of a worldwide database of men with prostate cancer (PCa) on active surveillance (AS) shows that 43.6% drop out of AS within 5 yr, mainly due to signs of disease progression. Better tools are needed to select and monitor men with PCa as part of AS.

UR - http://www.scopus.com/inward/record.url?scp=85055553741&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055553741&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2018.10.025

DO - 10.1016/j.eururo.2018.10.025

M3 - Article

C2 - 30385049

AN - SCOPUS:85055553741

VL - 75

SP - 523

EP - 531

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 3

ER -

Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium, Members of the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance GAP3 consortium. Reasons for Discontinuing Active Surveillance: Assessment of 21 Centres in 12 Countries in the Movember GAP3 Consortium. European Urology. 2019 Mar 1;75(3):523-531. https://doi.org/10.1016/j.eururo.2018.10.025