Page 11 - CUA 2020_Endourology

Unmoderated Posters 1: Prostate Cancer, Endourology, BPH

grade group ≥2. All of these patients had RP due to an upgraded biopsy (1; UP-1.16. Table 2. Responses of survey respondents
4%) or clinical judgment, such as rising prostate-specific antigen or con-
cerning MRI (22; 96%). Prostatectomy pathology revealed grade group ≥2 How beneficial do you feel MDCs are in
in 15 (65%) patients in the biopsy cohort. In the no-biopsy cohort (n=47), management of PCa? (n=211)
39 (82%) had grade group ≥2 on prostatectomy pathology. For patients No benefit 12 (5.7)
with PIRADS ≤3, two (50%) had high-grade cancer in the biopsy group
compared to five (83%) in the no-biopsy group. For patients with PIRADS Slight benefit 32 (15.2)
4, eight (73%) had high-grade cancer in the biopsy group compared to Moderate benefit 51 (24.2)
seven (64%) in the no-biopsy group. For patients with PIRADS 5, five Very beneficial 74 (35.1)
(63%) had high-grade cancer in the biopsy group compared to 27 (90%)
in the no-biopsy group. Extremely beneficial 42 (19.9)
Conclusions: In this cohort, we found that omitting post-MRI biopsy prior How beneficial do you feel PCa MDCs are in
to RP did not result in significant over treatment regardless of MRI find- promoting research (n=210)
ings. Validation in other cohorts or in a randomized trial is encouraged. No benefit 8 (4.8)
Slight benefit 21 (10.0)
UP-1.16 Moderate benefit 47 (22.4)
Multidisciplinary clinics in prostate cancer management:
Knowledge, attitudes, and utilization among urologists Very beneficial 95 (45.2)
Connor Hoge , Matt Kasson , Tianyuan Guan , Rand Naffouje , Timothy Extremely beneficial 39 (18.6)
1
1
2
1
Struve , Sadhna Verma , Abhinav Sidana 1 MDC patient population (n=107)
4
3
1 Department of Urology, University of Cincinnati College of Medicine,
Cincinnati, OH, United States; Department of Hematology and Oncology, Gleason 6 73 (68.2)
2
University of Cincinnati College of Medicine, Cincinnati, OH, United Gleason 7 86 (80.4)
States; Department of Radiation Oncology, University of Cincinnati Gleason 8–10 89 (83.2)
3
College of Medicine, Cincinnati, OH, United States; Department of
4
Radiology, University of Cincinnati College of Medicine, Cincinnati, Active surveillance 61 (57.0)
OH, United States Advanced/metastatic 78 (72.9)
Introduction: Multidisciplinary clinics (MDCs) have a growing role in the Recurrent disease 40 (37.4)
evaluation and treatment of prostate cancer (PCa). Such a clinic allows for
Reasons for not participating in MDC (n=104)
Lack of benefit 11 (10.6)
UP-1.16. Table 1. Characteristics and responses on use of
MDC survey Insufficient time 34 (32.7)
Participate in a MDC? (n=211) Cost 23 (22.1)
Lack of infrastructure 68 (65.4)
Yes 107 (51.0)
No 104 (49.3)
synchronous care, where multiple specialists see the patient at the same
Age (n=172), mean (±SD) 50.6 (12.1)
location and day. We aim to evaluate the current knowledge, attitude,
Gender (n=208) 41 (47.1) and practice patterns of urologists regarding PCa MDC, as well as analyze
Male 203 (97.6) predictors for their utilization.
Methods: A 14-item questionnaire was designed to collect information on
Female 5 (2.4)
urologists’ preferences and practice patterns regarding MDCs. The survey
Practice type (n=210) was sent to the members of the Society of Urologic Oncology and the
Academic 129 (61.4) Endourological Society. Data was analyzed using R (R Core team, 2017).
Results: A total of 211 responses were received and summarized in Tables
Non-academic 81 (38.6)
1 and 2. Overall, only 50.1% of respondents use MDCs, of which the
Years in practice (n=211) majority (65.4%) of participants practice in an academic institution.
0–5 31 (14.7) However, only 53.3% of oncology fellowship-trained urologists reported
participating in a MDC; 94.3% of all urologists surveyed felt MDCs were
6–10 35 (16.6)
useful for PCA treatment. A large majority of surgeons feel that MDCs
11–20 60 (28.4) are at least moderately beneficial for PCa treatment (79.0%; p<0.001).
>20 85 (40.3) Additionally, surgeons participating in MDCs were 2.58x more likely to
choose “extremely” beneficial than those who do not (odds ratio 2.58;
Fellowship-trained in urologic oncology (n=210)
p=0.008). Clinically localized high-risk PCa (Gleason 8–10) constitute
No 105 (50.0) the most common reason for referral to MDC (83.2%). Of those who do
Yes 105 (50.0) not use a MDC, the most common reasons cited were lack of infrastruc-
ture (65.4%) and time (32.7%). Age, practice type, years of practice,
Number of patients seen monthly with newly and number of newly diagnosed PCa patients seen per month were not
diagnosed PCa? (n=211)
significant predictors for use of MDCs.
None 4 (1.9) Conclusions: Despite literature indicating the utility of MDCs, as well as
1–5 68 (32.2) widespread belief in their efficacy, many surgeons deny participating in
them. Further studies are necessary to pursue potential solutions to major
6–10 68 (32.2)
barriers of MDC adaptation.
11–20 46 (21.8)
>20 25 (11.9)
Age, practice type, years of practice, and number of newly diagnosed PCa patients seen
per month were not significant predictors for use of MDCs.
CUAJ • June 2020 • Volume 14, Issue 6(Suppl2) S49