Ability of 2 pretreatment risk assessment methods to predict prostate cancer recurrence after radical prostatectomy: data from CaPSURE.

Purpose: Two methods widely used to predict the risk of treatment failure after radical prostatectomy for localized prostate cancer are the 3 level D'Amico risk classification and the Kattan nomogram. Although they have been previously validated, to our knowledge they have not been compared in a community based cohort. We tested the 2 instruments in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) database, a national registry of patients with prostate cancer, to assess their accuracy in a community based cohort.

The changing face of low-risk prostate cancer: trends in clinical presentation and primary management.

Purpose: Early intervention for prostate cancer is associated with excellent long-term survival, but many affected men, especially those with low-risk disease characteristics, might not experience adverse impact to survival or quality of life were treatment deferred. We sought to characterize temporal trends in clinical presentation and primary disease management among patients with low-risk prostate cancer.

Methods: Data were abstracted from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), a disease registry of 8,685 men with various stages of prostate cancer.

The contemporary management of prostate cancer in the United States: lessons from the cancer of the prostate strategic urologic research endeavor (CapSURE), a national disease registry.

Purpose: The epidemiology and treatment of prostate cancer have changed dramatically in the prostate specific antigen era. A large disease registry facilitates the longitudinal observation of trends in disease presentation, management and outcomes.

Materials And Methods: The Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) is a national disease registry of more than 10000 men with prostate cancer accrued at 31 primarily community based sites across the United States.

Patterns of secondary cancer treatment for biochemical failure following radical prostatectomy: data from CaPSURE.

Purpose: Biochemical failure after definitive treatment for localized prostate cancer may occur in a substantial number of patients. The pattern and type of treatment offered to such patients have been poorly documented. We determined second treatment patterns in patients with biochemical failure following radical prostatectomy (RP).

Impact of patient educational level on treatment for patients with prostate cancer: data from CaPSURE.

Objectives: To examine the effect of a patient's educational level on treatment selection for patients with newly diagnosed prostate cancer. A patient's educational level may impact a patient's understanding and perception of the risks and benefits of the treatment options for prostate cancer.

Methods: We examined 3484 patients in CaPSURE with prostate cancer between 1992 and 2001.

Predictors of treatment after initial surveillance in men with prostate cancer: results from CaPSURE.

Purpose: Expectant management of prostate cancer or watchful waiting (WW) is a reasonable option for some men with clinically localized prostate cancer. We identified predictors of eventual prostate cancer treatment in a cohort of men initially choosing WW.

Materials And Methods: We identified 457 men in the Cancer of the Prostate Strategic Urologic Research Endeavor data base selecting WW as initial management without subsequent treatment for at least 6 months.

Time trends in clinical risk stratification for prostate cancer: implications for outcomes (data from CaPSURE).

Purpose: Many instruments designed to predict prostate cancer risk use a combination of clinical T stage, biopsy Gleason score and serum prostate specific antigen (PSA). We designed a study to characterize time trends in these parameters and their impact on patient risk stratification.

Materials And Methods: Data were abstracted from CaPSURE (Cancer of the Prostate Strategic Urological Research Endeavor), a disease registry of 8,685 men with prostate cancer.

Fear of cancer recurrence in patients undergoing definitive treatment for prostate cancer: results from CaPSURE.

Purpose: Contemporary cancer treatments have resulted in patients living longer but with the risk of disease recurrence. Studies suggest that fear of recurrence is a significant burden. We described fear of cancer recurrence in patients with prostate cancer undergoing treatment with radical prostatectomy (RP), radiation (XRT) or brachytherapy (BT).

Health related quality of life patterns in patients treated with interstitial prostate brachytherapy for localized prostate cancer--data from CaPSURE.

Purpose: We measured the impact brachytherapy monotherapy (BMT) has on general and disease specific health related quality of life (HRQOL) compared to patients treated with radical prostatectomy (RP).

Materials And Methods: We studied 419 men with newly diagnosed prostate cancer who enrolled in CaPSURE (Cancer of the Prostate Strategic Urological Research Endeavor) data base whose primary treatment was brachytherapy monotherapy (92) or radical prostatectomy (327). The validated RAND 36-Item Health Survey and the UCLA Prostate Cancer Index were used to measure HRQOL before treatment and at 6-month intervals during the first 2 years after treatment.

Time trends and characteristics of men choosing watchful waiting for initial treatment of localized prostate cancer: results from CaPSURE.

Purpose: Watchful waiting (WW) is one option for men with clinically localized prostate cancer. We examined temporal trends in the use of WW, as well as sociodemographic and clinical profiles of men who choose this form of management.

Materials And Methods: The Cancer of the Prostate Strategic Urologic Research Endeavor is a national registry of patients with various stages of prostate cancer.

Sociodemographic and clinical risk characteristics of patients with prostate cancer within the Veterans Affairs health care system: data from CaPSURE.

Purpose: Veterans Affairs (VA) health care system investigators perform large clinical trials in prostate cancer treatment but potential differences between VA and other patient cohorts have not been explored systematically.

Materials And Methods: Cancer of the Prostate Strategic Urologic Research Endeavor is an ongoing observational database of men with prostate cancer, comprising 7,202 patients treated at 35 sites across the United States. Three sites that together contribute 241 patients are VA medical centers.

Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged.

Unlabelled: Postoperative pain can have a significant effect on patient recovery. An understanding of patient attitudes and concerns about postoperative pain is important for identifying ways health care professionals can improve postoperative care. To assess patients' postoperative pain experience and the status of acute pain management, we conducted a national study by using telephone questionnaires.

Temporal trends in radical prostatectomy complications from 1991 to 1998.

Purpose: We performed a retrospective, longitudinal, population based study to ascertain whether radical prostatectomy outcomes improved after the diffusion of surgical innovations during the last decade.

Materials And Methods: Using a 5% national random sample of Medicare beneficiaries we identified 12,079 men who underwent radical prostatectomy from 1991 to 1998. We analyzed relevant Medicare data to establish length of stay and the rate of in hospital complications (cardiac, respiratory, vascular, wound and genitourinary conditions) as well as the rate of anastomotic stricture, incontinence and impotence through 36 months after surgery.

Role of surgeon volume in radical prostatectomy outcomes.

Purpose: To examine the effect of hospital and surgeon volume on postoperative outcomes and to determine whether hospital or surgeon volume is the stronger predictor.

Patients And Methods: Using 1997 to 1998 claims data from a national 5% random sample of Medicare beneficiaries, we identified 2,292 men who underwent radical prostatectomy at 1,210 hospitals by 1,788 surgeons. Hospitals were classified as high (> or = 60 per year) or low (< 60 per year) volume according to radical prostatectomy experience over the 2-year period.

How potent is potent? Evaluation of sexual function and bother in men who report potency after treatment for prostate cancer: data from CaPSURE.

Objectives: To characterize the association between potency and comprehensive sexual function. The accurate assessment of sexual function is critical for the evaluation of outcomes after treatment of prostate cancer. The assessments of potency typically used in this context, however, may be oversimplified.

Predicting recurrence after radical prostatectomy for patients with high risk prostate cancer.

Purpose: Previous studies have shown that patients with clinical stage T2c-T3 prostate cancer, serum prostate specific antigen (PSA) at diagnosis greater than 20 ng./ml. or a biopsy Gleason score of 8 to 10 are at high risk for disease recurrence after radical prostatectomy.

Is ethnicity an independent predictor of prostate cancer recurrence after radical prostatectomy?

Purpose: Prostate cancer incidence and mortality are higher in black than in white American men. We determined whether ethnicity is an independent predictor of disease recurrence in men undergoing radical prostatectomy.

Materials And Methods: We studied 1,468 patients who underwent radical prostatectomy at the University of California, San Francisco or as part of the Cancer of the Prostate Strategic Urological Research Endeavor database, a longitudinal disease registry of patients with prostate cancer.

Psychological impact of erectile dysfunction: validation of a new health related quality of life measure for patients with erectile dysfunction.

Purpose: Male erectile dysfunction has a substantial impact on health related quality of life. We examined the psychometric properties of 2 new scales created to measure the psychological impact of erectile dysfunction.

Materials And Methods: Patients enrolled in a long-term study of men with erectile dysfunction completed clinical and health related quality of life information at baseline and at 3 followup points.

Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer.

Although once reserved for the management of metastatic prostate cancer, androgen deprivation therapy (ADT) is being used increasingly to treat lower stages of disease. We sought to assess patterns of ADT use in a contemporary cohort of men newly diagnosed with prostate cancer. Men with newly diagnosed prostate cancer who had > or =12 months of follow-up evaluation were identified in a national disease registry of patients with prostate cancer.

Predictors of secondary cancer treatment in patients receiving local therapy for prostate cancer: data from cancer of the prostate strategic urologic research endeavor.

Purpose: Secondary cancer treatment is common after definitive local therapy for prostate cancer and it may be an indicator of the efficacy and cost of primary local treatment. We determined predictors of secondary cancer treatment in patients initially treated with radical prostatectomy or external beam radiation.

Materials And Methods: We examined 2,336 patients in Cancer of the Prostate Strategic Urologic Research Endeavor, a longitudinal registry of patients with prostate cancer, who underwent initial treatment with radical prostatectomy (1,744) or external beam radiation (592).

Contemporary trends in imaging test utilization for prostate cancer staging: data from the cancer of the prostate strategic urologic research endeavor.

Purpose: Previous investigators have reported widespread overuse of imaging tests for staging clinically localized prostate cancer. In this study imaging test utilization rates were analyzed in a contemporary group of patients, and clinical and demographic predictors of testing were identified.

Materials And Methods: Data were abstracted from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), a longitudinal registry of men with various stages of prostate cancer.

Health outcomes assessment in community pharmacy practices: a feasibility project.

Objectives: To evaluate the feasibility and benefit of capturing outcomes data in community pharmacy settings, and to characterize the health status, resource use, and medication use of patients with musculoskeletal disorders.

Methods: Patients (n = 460) with musculoskeletal disorders including osteoarthritis (OA), rheumatoid arthritis (RA), and low back pain from 12 community pharmacy sites responded to disease-specific questions, the Medical Outcomes Study Short Form-36 (SF-36) health survey, demographics, and resource use using touch screen computer technology. Patients provided information and met with a community pharmacist for scheduled visits at baseline, 3, 6, 9, and 12 months.

Predicting disease recurrence in intermediate and high-risk patients undergoing radical prostatectomy using percent positive biopsies: results from CaPSURE.

Objectives: To determine whether percent positive biopsies could be used to predict the probability of disease recurrence in contemporary patients undergoing radical prostatectomy in community-based practice settings. Previous studies have demonstrated the importance of systematic prostate biopsy results in the risk assessment for newly diagnosed patients with prostate cancer.

Methods: We studied 1265 patients enrolled in CaPSURE (a longitudinal registry of patients with prostate cancer) who underwent radical prostatectomy as definitive local treatment of their prostate cancer.

Study of Hypertensive Prescribing Practices (SHyPP): A National Survey of Primary Care Physicians.

BACKGROUND: Approximately 50 million people in the U.S. have hypertension.