Prostate cancer outcomes and delays in care

Michael E. O’Callaghan, Zumin Shi, Tina Kopsaftis, Kim Moretti

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: To examine the survival effect of treatment delays from the time of confirmed diagnosis of prostate cancer to first treatment in an Australian population. Methods: Three thousand one hundred and forty patients were identified from the South Australian Prostate Cancer Clinical Outcomes Collaborative database for analysis. Selected patients had dates recorded for both diagnosis and treatment. We examined the effect of treatment delay (the time from diagnosis to date of first treatment) on survival using Cox and competing risks regression and compared quartiles of delay across the cohort. Adjustment was made for age, PSA levels, treatment modality and Gleason score. Outcomes included overall survival (OS) and prostate cancer-specific mortality (PCSM). Results: Quartiles of delay were as follows (days)—Q1: 35, Q2: 86, Q3: 138.0, Q4: 264. Shorter delays were associated with hormonal treatment, high Gleason score and high PSA values. Measuring PCSM with Q2 as reference, age-adjusted associations were—Q1: sHR 4.37 (2.75–6.94), Q3: sHR 1.29 (0.73–2.28), Q4: sHR 1.55 (0.91–2.63). After additional adjustment for treatment type, Gleason score and PSA, Q1 remained at increased risk [sHR 2.46 (1.10–5.54)]. A similar trend was observed for OS. In analysis stratified by Gleason score, delays were not significantly associated with OS. Conclusions: Factors associated with shorter delay in treatment include high Gleason score, high PSA and hormonal treatment. After adjustment for these variables, increased delays were not associated with OS or PCSM in this cohort. The nonlinear association of delay with risk may explain conflicting reports in the literature.

LanguageEnglish
Pages449-455
Number of pages7
JournalInternational Urology and Nephrology
Volume49
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

Keywords

  • Biochemical recurrence
  • Delay
  • Health services research
  • Prostate cancer

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

O’Callaghan, M. E., Shi, Z., Kopsaftis, T., & Moretti, K. (2017). Prostate cancer outcomes and delays in care. International Urology and Nephrology, 49(3), 449-455. https://doi.org/10.1007/s11255-017-1508-z
O’Callaghan, Michael E. ; Shi, Zumin ; Kopsaftis, Tina ; Moretti, Kim. / Prostate cancer outcomes and delays in care. In: International Urology and Nephrology. 2017 ; Vol. 49, No. 3. pp. 449-455.
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O’Callaghan, ME, Shi, Z, Kopsaftis, T & Moretti, K 2017, 'Prostate cancer outcomes and delays in care', International Urology and Nephrology, vol. 49, no. 3, pp. 449-455. https://doi.org/10.1007/s11255-017-1508-z

Prostate cancer outcomes and delays in care. / O’Callaghan, Michael E.; Shi, Zumin; Kopsaftis, Tina; Moretti, Kim.

In: International Urology and Nephrology, Vol. 49, No. 3, 01.03.2017, p. 449-455.

Research output: Contribution to journalArticle

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