The following is a summary of “Patterns of multispecialty care for low- and intermediate-risk prostate cancer in the use of active surveillance,” published in the  September 2023  issue of Urologic Oncology: Seminars and Original Investigations by Zambrano, et al.

Prostate cancer (PC) patients should benefit from multidisciplinary care models that encourage collaborative decision-making and streamline the delivery of high-quality treatment. There still needs to be more clarity on the applicability of this strategy to low-risk diseases, for which expectant care is the recommended option. Therefore, researchers looked at the most up-to-date trends in specialized visits for low/intermediate-risk PC and the resulting usage of AS. From 2010-2017, they analyzed SEER-Medicare data to determine whether newly diagnosed PC patients saw urologists and radiation oncologists (i.e. multispecialty treatment) or urologists only. Without treatment within 12 months of diagnosis, they also looked at the correlation with AS. 

The Cochran-Armitage test was used to examine the temporal trends. The socioeconomic and clinicopathologic features of various care models were compared using chi-squared and logistic regression tests. The percentage of patients who saw both experts was 35.5% for those at low risk and 46.5% for those at intermediate risk. The percentage of low-risk patients receiving care from multiple specialists has decreased over the past few years (from 44.1% to 25.3%, 2010–2017; P< 0.001). 

Patients who saw urologists saw a 40.9% increase to 68.6% (P<0.001), while those who visited both specialists saw a 13.1% increase to 24.6% (P< 0.001). Multispecialty care was predicted by age, urban location, higher education, SEER area, comorbidities, frailty, and Gleason score (all P<0.02). Urologists have been responsible for the majority of AS adoption among men with low-risk PC. Although selection has a role, these findings suggest that AS may not need to be promoted through multispecialty treatment for men with low-risk PC.

Source: sciencedirect.com/science/article/abs/pii/S1078143923001400#abs0002