J Cancer 2019; 10(6):1496-1502. doi:10.7150/jca.29595
Current Treatment for Low-Risk Prostate Cancer in China: A National Network Survey
1. Shengli Clinical Medical College, Fujian Medical University, Fuzhou 350001, China;
2. Department of Urology, Fujian Provincial Hospital, No.134 Dong Street, Fuzhou 350001, China;
3. Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410000;
4. Department of Urology, the 118th Hospital of PLA, Wenzhou, 325000;
5. Department of Urology, the Hunan Provincial People's Hospital, Changsha 410005;
6. Department of Urology, The First Affiliated Hospital of Fujian Medical University, Longyan, 364000;
7. Department of Urology, Affiliated hospital of Jining Medical University, Jining, 272000;
8. Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, 510095;
9. Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai 200433;
10. Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, 430071;
11. Department of Urology,Nanchong Central Hosipital, Nanchong, 637000;
12. Jiujing, new medium team of Chinese Urologists, PR China.
Objective: To analyze the current treatment for low-risk prostate cancer (LRPC) in China.
Methods: A national questionnaire survey titled “A survey of current treatment of LRPC” was designed and released nationally through the network from July 16 to August 3, 2017.
Results: A total of 1,116 valid questionnaires were recovered. The percentages of preferred treatment by active surveillance (AS) or radical prostatectomy (RP) were 29.21% and 45.61%, respectively. A correspondence analysis showed that the physician in charge was more inclined to choose AS than RP. Respondents from different institution types, hospitals with different annual numbers of newly admitted patients with prostate cancer, and with different familiarity with the LRPC definition presented a significant difference in the preferred treatments (p < 0.05). Urologists chose AS or not for the following reasons: tumor progression (52.51%), potential medical disputes (42.56%) (i.e., medical disputes from patients or their relatives when urologists choose AS to treat patients with LRPC and the patient has a poor outcome), fear of cancer (41.94%), and surgical risk (39.07%). These reasons were ubiquitous, and there was no significant difference among urologists for these concerns (p > 0.05). Personal skills, surgical risk, and tumor progression were the most common factors that influenced whether AS or RP was preferred (p < 0.05). Concern about the medical disputes brought about by AS was a key factor for not choosing AS (p < 0.05).
Conclusions: LRPC is still dominated by RP in China, followed by AS. Personal skills, surgical risk, and concern about tumor progression were the common factors influencing whether AS or RP was preferred. In addition, medical disputes brought by AS are another key factor for not choosing AS. There will be more Chinese data in the future to guide treatment of LRPC.
Keywords: prostate cancer, active surveillance, radical prostatectomy, urologist, China, survey
Wei Y, Liu L, Li X, Song W, Zhong D, Cao X, Yuan D, Ming S, Zhang P, Wen Y,