Page 4 - CUA2018 Abstracts - Oncology-Prostate

2018 CUA AbstrACts

Poster Session 1: Prostate Cancer I

June 25, 2018; 0800–0930

MP–1.1 3. Barry MJ, Fowler FJ, O’leary MP, et al. American Urological
Mental health outcomes in adult men with a history of prostate Association symptom index for benign prostatic hyperplasia. J Urol
cancer diagnosis 1992;148:1549–57. https://doi.org/10.1016/S0022–5347(17)36966–5
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Gabriela Ilie 1,2,3 , David Bell , Tetteh Ago , Gavin Langille , David Bowes , 4. Vodermaier A, Linden W. Emotional distress screening in Canadian
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Padraic O’Malley , Derek Wilke , Ricardo Rendon , Patil Nikhilesh , cancer care: A survey of utilization, tool choices and practice patterns.
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Gregory Bailly , Amanda Caissie , Robert Thompson , Larry Pan , Dilip Oncol Exchange 2008;7:37–40.
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Panjwani , Matthew Acker , Thomas Whelan , Joseph Lawen , John
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Grantmyre , Holly Campbell , P. Scott Bagnell , Manpreet Tiwana , James MP–1.2
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E. Ashfield , Robert Rutledge 2,5 Are urologic surgeons performing radical prostatectomy at the
1 Urology, Dalhousie University, Halifax, NS, Canada; Radiation Oncology, University of Alberta providing high–quality and uniform prostate
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Dalhousie University, Halifax, NS, Canada; Community Health and cancer control?
Epidemiology, Dalhousie University, Halifax, NS, Canada; Urology, Halifax Trevor Haines , Sunita Ghosh , Niels Jacobsen , Benjamin Beech , Jan
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Infirmary – QEII – Nova Scotia Health Authority, Halifax, NS, Canada; Nova Rudzinski , Ryan McLarty , Nick Dean , Steven Tong , Dylan Hoare , Adrian
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Scotia Cancer Centre, Queen Elizabeth II Health Sciences Centre, Halifax, Fairey 1
NS, Canada; Urology, Saint John Regional Hospital – Horizon Health 1 Urology, University of Alberta, Edmonton, AB, Canada; Oncology,
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Network, St. John’s, NB, Canada; Radiation Oncology, Saint John Regional University of Alberta, Edmonton, AB, Canada
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Hospital – Horizon Health Network, St. John’s, NB, Canada; PEI Cancer Introduction: The 2010 Canadian Urological Association consensus guide-
Treatment Centre , Queen Elizabeth Hospital, Charlottetown, PE, Canada line examining surgical quality performance for radical prostatectomy (RP)
Study Groups: Dalhousie Medical Research Foundation – Soillse Fund. states that urologic surgeons should achieve an unadjusted positive surgical
Introduction: We aimed to examine the burden of mental health in a popu- margin (R1) rate <25% for organ–confined (i.e., pT2) disease. To date, no
lation–based cohort of adult men with localized prostate cancer residing in study has examined whether Canadian urologic surgeons are achieving this
one of three Maritimes provinces in Canada and to evaluate associations benchmark. The primary objective of the current study was to determine
with current urinary, sleep problems, and relationship difficulties. the proportion of urologic surgeons achieving an unadjusted pT2–R1 rate
Methods: A total of 151 men, who were 50 years of age or older (mean <25%. A secondary objective was to determine whether between–surgeon
68.39, standard deviation [SD] 6.45 years) with a history of clini- variation (i.e., heterogeneity) exists in pT2–R1 rates.
cally localized prostate cancer completed an online 15–minute survey Methods: A retrospective analysis of prospectively collected data from the
between May 2017 and March 2018 assessing patient reported qual- University of Alberta (UA) Radical Prostatectomy Database was performed.
ity of life outcomes. The primary outcome of interest was a validated Men who underwent RP for clinically localized prostate cancer between
assessment of mental health disorder, Kessler Psychological Distress Scale September 2007 and August 2017 by one of nine urologic surgeons were
(K10). Urinary problems were assessed using the International Prostate analyzed. The primary outcome was pT2–R1 rate. General anatomical
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Symptom Score (IPSS). Sleep and relationship difficulties were assessed pathologists at two sites reviewed RP specimens. A R1 was defined as
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using the Screening for Distress questionnaire. 4 the presence of cancer at the inked margin. Multivariable random effects
Results: A total of 16.1% men scored positive for mental health issues at models were used to evaluate heterogeneity in pT2–R1 rates after adjust-
the time the survey was completed. In this sample, 12.6% of participants ment for case mix. Statistical tests were two–sided (p≤0.05).
were currently on active surveillance and 87.4% reported having been Results: Pathological data were evaluable for 1870 patients; 1323 of 1870
treated with active treatment modalities (e.g., surgery, radiation, hormonal patients (71%) had pT2 disease. Six of nine surgeons achieved unadjusted
manipulation). Half of the sample (50%) reported mild, 45% moderate, pT2–R1 rates <25%. Three surgeons had unadjusted pT2–R1 rates ≤15%,
and 5% severe urinary problems. Relative risk was 1.70 (95% confidence whereas three surgeons had unadjusted pT2–R1 rates ≥28%. Multivariable
interval [CI] 1.21–2.38) for screening positive for mental health problems random effects models showed statistically significant between–surgeon
among survivors with moderate to severe urinary problems compared with variation in pT2–R1 rates (p=0.024).
those with mild urinary problems. Relative risk for screening positive for Conclusions: UA urologic surgeons are not all achieving the CUA pT2–R1
mental health problems among survivors with sleep problems and current benchmark for surgical quality performance for radical prostatectomy. A
worries about relationship difficulties was 3.24 (95% CI 1.53–6.86) and patient’s likelihood of achieving optimal cancer control differs depending
2.99 (95% CI 1.43–6.26), respectively, compared with those with no sleep on which urologic surgeon performs his surgery. Surgical quality perfor-
problems and worries about relationship difficulties. mance initiatives designed to improve pT2–R1 rates of radical prostatectomy
Conclusions: Older men with urinary, sleep, and relationship difficulties are warranted.
problems are at higher risk of having mental health problems after diagnosis
and treatment of prostate cancer.
References:
1. Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to moni-
tor population prevalences and trends in non–specific psychologi-
cal distress. Psychol Med 2002;32:959–76. https://doi.org/10.1017/
S0033291702006074
2. Andrews G, Slade T. Interpreting scores on the Kessler Psychological
Distress Scale (k10). Aust N Z J Public Health 2001;25:494–7. https://
doi.org/10.1111/j.1467–842X.2001.tb00310.x
S62 CUAJ • June 2018 • Volume 12(6Suppl2)
© 2018 Canadian Urological Association