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Randomized Controlled Trial
. 2014 Dec;17(6):776-83.
doi: 10.1111/j.1369-7625.2012.00802.x. Epub 2012 Jul 19.

Effect of intervention on decision making of treatment for disease progression, prostate-specific antigen biochemical failure and prostate cancer death

Rex C-C Huang  1 , Anssi Auvinen, Matti Hakama, Teuvo L J Tammela, Martti Ala-Opas, Mikael Leppilahti, Timo Vornanen, Hsiu-Hsi Chen
Affiliations
Randomized Controlled Trial

Effect of intervention on decision making of treatment for disease progression, prostate-specific antigen biochemical failure and prostate cancer death

Rex C-C Huang et al. Health Expect. 2014 Dec.

Abstract

Background: Patient preference for the choice of treatment modality for prostate cancer has increasingly gained attention.

Objective: To assess the impact of client-oriented decision on long-term mortality, disease progression and biochemical failure compared with standard treatment protocol (TP).

Methods: With 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.

Results: Patients 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.

Conclusions: Patients 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.

Keywords: patient preference; prostate cancer; survival; treatment modality.

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Figures

Figure 1
Figure 1
The flowchart of the recruitment and allocation in the randomized controlled trial of the choice of treatment for prostate cancer patients.
Figure 2
Figure 2
Cumulative disease‐specific survival by trial arm (intervention: EPP, enhanced patient participation; control: TP, treatment protocol).
Figure 3
Figure 3
Cumulative survival of being free of biochemical failure by trial arm (intervention: EPP, enhanced patient participation; control: TP, treatment protocol).
Figure 4
Figure 4
Cumulative progression‐free survival by trial arm (intervention: EPP, enhanced patient participation; control: TP, treatment protocol).
See this image and copyright information in PMC

References

    1. Auvinen A, Vornanen T, Tammela TLJ et al A randomized trial of choice of treatment in prostate cancer: design and baseline characteristics. BJU International, 2001; 88: 708–715. - PubMed
    1. Davison BJ, Goldenberg SL, Gleave ME, Degner LF. Provision of individualized information to men and their partners to facilitate treatment decision making in prostate cancer. Oncology Nursing Forum, 2003; 30: 107–114. - PubMed
    1. Davison BJ, Goldenberg SL. Decisional regret and quality of life after participating in medical decision‐making for early‐stage prostate cancer. BJU International, 2003; 91: 14–17. - PubMed
    1. Auvinen A, Hakama M, Ala‐opas M et al A randomized trial of choice of treatment in prostate cancer: the effect of intervention on the treatment chosen. BJU International, 2004; 88: 52–56. - PubMed
    1. Holmberg L, Bill‐Axelson A, Helgesen F et al A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. New England Journal of Medicine, 2002; 347: 781–789. - PubMed

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