Dueling active surveillance: does utilization of active surveillance for low risk prostate cancer correspond with utilization of active surveillance for small renal masses?

You have accessJournal of UrologyCME1 Apr 2023MP64-10 DUELING ACTIVE SURVEILLANCE: DOES UTILIZATION OF ACTIVE SURVEILLANCE FOR LOW RISK PROSTATE CANCER CORRESPOND WITH UTILIZATION OF ACTIVE SURVEILLANCE FOR SMALL RENAL MASSES? Michael Wang, Sophie Wittenberg, Michael Cher, JI Qi, Stephanie Ferrante, Mahin Mirza, Anna Johnson, Alice Semerjian, Arvin George, Craig Rogers, Samantha Wilder, Richard Sarle, Khurshid Ghani, Brian Lane, Kevin Ginsburg, and For The Michigan Urological Surgery IMPROVEMENT Collaborative Michael WangMichael Wang More articles by this author , Sophie WittenbergSophie Wittenberg More articles by this author , Michael CherMichael Cher More articles by this author , JI QiJI Qi More articles by this author , Stephanie FerranteStephanie Ferrante More articles by this author , Mahin MirzaMahin Mirza More articles by this author , Anna JohnsonAnna Johnson More articles by this author , Alice SemerjianAlice Semerjian More articles by this author , Arvin GeorgeArvin George More articles by this author , Craig RogersCraig Rogers More articles by this author , Samantha WilderSamantha Wilder More articles by this author , Richard SarleRichard Sarle More articles by this author , Khurshid GhaniKhurshid Ghani More articles by this author , Brian LaneBrian Lane More articles by this author , Kevin GinsburgKevin Ginsburg More articles by this author , and For The Michigan Urological Surgery IMPROVEMENT Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003322.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance (AS) is the recommended management strategy for men with low-risk prostate cancer (CaP). Similarly, AS has been shown to be safe for patients with renal masses <4 cm (cT1aRM). Here, we assessed surgeon-level practice patterns for the use of AS in patients with GG1 CaP and cT1aRM. We hypothesized that the proportion of a urologist’s patients with CaP managed with AS will correlate with the use of AS for their patients with cT1aRM. METHODS: We reviewed practice patterns of surgeons in the Michigan Urological Surgery Improvement Collaborative (MUSIC). Urologists were included if they managed at least 10 GG1 CaP and 10 cT1aRM patients between 2017 and 2021. Using the Chi-squared test, we compared the proportions of cT1aRM patients managed with AS among surgeons in the lowest and highest quartile of AS use for those with GG1 CaP. We fit separate multivariable mixed-effects logistic regression models to obtain risk-adjusted proportions of a urologist’s patients with GG1 CaP and cT1aRM managed with AS. Correlation between a surgeon’s risk-adjusted use of AS for the two groups was assessed with Pearson’s correlation coefficient. RESULTS: 27 urologists met the inclusion criteria. 82% of men with GG1 CaP were managed on AS compared with 49% of men with cT1aRM. Among the surgeons in the lowest quartile of AS use for CaP (<71% of men with GG1 CaP managed on AS), 33% of men with cT1aRMs were managed with AS compared to 49% of men with cT1aRMs managed by the surgeons in the highest quartile of CaP AS use (>89% of men with GG1 CaP managed with AS, p<0.001, Figure 1). There was a modest positive correlation between the proportion of a surgeon’s men with GG1 prostate cancer and cT1aRM managed with AS (correlation coefficient: 0.47, p=0.014). CONCLUSIONS: There is marked variability in the use of AS for patients with GG1 CaP and cT1aRMs by surgeons. Those that are low utilizers of AS for men with GG1 CaP used less AS for patients with cT1aRM compared with surgeons that are high utilizers of AS for GG1 CaP. Thus, urologists who use AS for GG1 CaP are more likely to use AS for patients cT1aRM, while those that are more likely to operatively manage one low risk malignancy are likely to also operate on a second low risk malignancy. Source of Funding: funding from Blue Cross Blue Shield of Michigan © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e884 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Wang More articles by this author Sophie Wittenberg More articles by this author Michael Cher More articles by this author JI Qi More articles by this author Stephanie Ferrante More articles by this author Mahin Mirza More articles by this author Anna Johnson More articles by this author Alice Semerjian More articles by this author Arvin George More articles by this author Craig Rogers More articles by this author Samantha Wilder More articles by this author Richard Sarle More articles by this author Khurshid Ghani More articles by this author Brian Lane More articles by this author Kevin Ginsburg More articles by this author For The Michigan Urological Surgery IMPROVEMENT Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...