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Variability in the multicentre National Registry in Active Surveillance; a questionnaire for urologists.

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2018-04-13

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Rubio-Briones, J
Borque-Fernando, A
Esteban-Escaño, L M
Martínez-Breijo, S
Medina-López, R
Hernández, V
en representación del Grupo Colaborativo PIEM-AEU Vigilancia Activa 2014 001 NCT02865330

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Abstract

Our main objective was to report the current use of active surveillance in Spain and to identify areas for potential improvement. A questionnaire generated by the Platform for Multicentre Studies of the Spanish Urology Association (AEU/PIEM/2014/0001, NCT02865330) was sent to all associate researchers from January to March 2016. The questionnaire included 7 domains covering various aspects of active surveillance. Thirty-three of the 41 associate researchers responded to the questionnaire. Active surveillance is mainly controlled by the urology departments (87.9%). There was considerable heterogeneity in the classical clinical-pathological variables as selection criteria. Only 36.4% of the associate researchers used prostate-specific antigen density (PSAd). Multiparametric magnetic resonance imaging (mpMRI) was clearly underused as initial staging (6%). Only 27.3% of the researchers stated that their radiology colleagues had a high level of experience in mpMRI. In terms of the confirmation biopsy, most of the centres used the transrectal pathway, and only 2 out of 33 used the transperineal pathway or fusion software. Half of the researchers interviewed applied active treatment when faced with disease progression to Gleason 7 (3+4). There was no consensus on when to transition to an observation strategy. The study showed the underutilisation of informed consent and quality-of-life questionnaires. PSAd was not included as a decisive element in the initial strategy for most researchers. There was a lack of confidence in the urologists' mpMRI experience and an underutilisation of the transperineal pathway. There was also no consensus on the follow-up protocols and active treatment criteria, confirming the need for prospective studies to analyse the role of mpMRI and biomarkers.

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Health Care Surveys
Humans
Male
Prostatic Neoplasms
Registries
Spain
Urology
Watchful Waiting

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Keywords

Active surveillance, Cuestionario, Cáncer de próstata, Prostate cancer, Questionnaire, Vigilancia activa

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