Effect of intervention on decision making of treatment for disease progression,prostate‐specific antigen biochemical failure and prostate cancer death |
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| Authors: | Rex C.‐C. Huang MS Anssi Auvinen PhD Matti Hakama PhD Teuvo L. J. Tammela PhD Martti Ala‐Opas PhD Mikael Leppilahti PhD Timo Vornanen MD Hsiu‐Hsi Chen PhD |
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| Affiliation: | 1. PhD Student, Tampere School of Public Health, University of Tampere, , Tampere, Finland;2. Professor of Epidemiology, Tampere School of Public Health, University of Tampere, , Tampere, Finland;3. Professor of Epidemiology, Finnish Cancer Registry, , Helsinki, Finland;4. Professor of Epidemiology, Department of Urology, Tampere University Hospital and University of Tampere, , Tampere, Finland;5. Professor of Urology, Department of Urology, Helsinki University Hospital, , Helsinki, Finland;6. Professor of Surgery, Department of Surgery, Sein?joki Hospital, , Sein?joki, Finland;7. Professor of Surgery, Department of Surgery, Kymenlaakso Central Hospital, , Kotka, Finland;8. Professor of Biostatistics, Tampere School of Public Health, University of Tampere, , Tampere, Finland;9. Professor of Biostatistics, Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, , Taipei, Taiwan |
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| Abstract: | BackgroundPatient preference for the choice of treatment modality for prostate cancer has increasingly gained attention.ObjectiveTo assess the impact of client‐oriented decision on long‐term mortality, disease progression and biochemical failure compared with standard treatment protocol (TP).MethodsWith data from a Finnish multicentre, randomized controlled trial with two arms [104 in the enhanced patient participation (EPP) arm and 106 in the TP arm], disease‐specific and disease‐free survival, biochemical failure with elevated prostate‐specific antigen (PSA) level and disease progression were compared between the two arms using Wilcoxon test and also Cox proportional hazards regression model.ResultsPatients in the EPP arm had a higher risk of death by 37% [HR, 1.37 (0.87–2.17)] compared with those in the TP arm. Patients in the EPP arm were at increased risk of having biochemical failure by 14% [HR, 1.14 (0.72–1.79)] and for having disease progression by 2% [HR, 1.02 (0.61–1.70)] compared with those in the TP arm. All the differences were non‐significant.ConclusionsPatients actively involved in the choice of treatment had higher risk of prostate cancer death but only slightly increased risk of biochemical failure and clinical disease progression. These findings would provide a good reference when patient autonomy for the choice of treatment modality is addressed. |
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| Keywords: | patient preference prostate cancer survival treatment modality |
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