Page 486 - An Evidence Review of Active Surveillance in Men With Localized Prostate Cancer
P. 486

Appendix Table C4.2. Comparison between watchful waiting and radical prostatectomy

                                        Author, Year         Study name       Comparison           Outcome            Followup      Sample size      Results                          Factors included in the
                                        [Pubmed ID]          /Database                             definition/        (yr)          per group                                         model
                                                                                                   measurement
                                        Study design                                               instrument
                                        Prostate-cancer
                                        specific
                                        mortality
                                        Bill-Axelson 213     SPCG-4           RP vs. WW            Death from         12.8          RP: 347          RR=0.62 (0.44, 0.87); P =        None (RCT)
                                        2011                                                       prostate cancer                  WW: 348          0.01
                                        21542742

                                        RCT
                                        Hadley 207           SEER-            RP vs.               Death from         Survival      RP: 11,936;      Unweighted regression            PS: age, race/ethnicity,
                                        2010                 Medicare         conservative         prostate cancer    was           conservative     analysis:                        marital status, tumor
                                        20944078                              management           from SEER          observed      management:  HR=0.62 (0.50, 0.79); P              characteristics, previous
                                                                                                   records.           for up to     5879             <0.001                           health problems (based
                                        Retrospective                                                                 12 years;                      PS reweighted analysis           on NCI combined
                                        cohort                                                                        mean          [calculated      using IPTW: HR=0.63 (0.55,       comorbidity index and
                                                                                                                      survival      based on the     0.71); P <0.001                  Medicare
                                                                                                                      time free     proportion of    PS reweighted analysis           reimbursements in the
                                                                                                                      of all        patients         using SMRW: HR=0.72              12 months before
                                                                                                                      cause-        treated with     (0.57, 0.91); P <0.001           diagnosis), year of
                                                                                                                      death =       each             IV regression using the          diagnosis. These
                                                                                                                      83.0 mo;      modality, for    previous year’s local area       variables were included
                                                                                                                      median        the overall      treatment pattern for            in all multivariable
                                                                                                                      survival      population]      conservative management          models.
                                                                                                                      time from                      as an instrument:
                                                                                                                      diagnosis                      HR=1.37 (0.15, 12.5); P =        Instrumental variable:
                                                                                                                      to Dec                         0.78)                            the lagged (previous
                                                                                                                        st
                                                                                                                      31 , 2008                                                       year’s) local area
                                                                                                                      (censoring                                                      treatment pattern for
                                                                                                                      date) = 78                                                      conservative
                                                                                                                      mo (IQR =                                                       management.
                                                                                                                      48 mo)

















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