Page 408 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer
P. 408

Appendix Table C3.1 Studies on offer, acceptance, and adherence of active surveillance (continued)
                                               Factors examined                    Author               Study approach                  AS/WW definitions                    Findings               Issues
                                                                                    Year
                                                                                   PMID
                                        Adherence to       Zietman 186       Retrospective study of 198 men          Surveillance/WW: no       •  81% believed that treatment       •  Nonvalidated
                                        AS (actually       2001              with early stage disease on WW in       primary treatment with    was desired by the physicians,       telephone survey (not
                                        receiving active   11586206          2 institutions, 63 of whom ultimately   radiation,                which was the primary cause of       described)
                                        treatment);                          received treatment; 53 of them          prostatectomy or          the change in plan.                  •  Retrospective
                                        clinical factors                     responded to an 8-point phone           androgen deprivation;     •  In contrast, MD notes             definition of WW
                                        (perception of                       questionnaire (10 did not respond       DRE & PSA q4-6 mo         revealed that for only 24% was       •  Only surveyed those
                                        physician                            because they had died, were too         (retrospective study)     there documentation that MDs         who received therapy
                                        advice)                              infirm or too elderly)                                            advocated therapy due to             •  Survey response rate
                                                                                                                                               clinical or biochemical evidence     84%
                                                                                                                                               of tumor progression.                •  Did not report on full
                                                                                                                                                 o  71% had PSA increase            survey results, including
                                                                                                                                                 only and 11% had no                the intended purposes of
                                                                                                                                                 progression evidence               influences that affected
                                                                                                                                               •  Physicians more often             decision
                                                                                                                                               perceived that treatment was
                                                                                                                                               initiated by patients (in abstract
                                                                                                                                               conclusions only)









































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