A decision analysis for treatment of clinically localized prostate cancer

Michael W. Kattan, Mark E. Cowen, Brian J. Miles

Research output: Contribution to journalArticlepeer-review

85 Scopus citations

Abstract

OBJECTIVE: To determine the preferred treatment of clinically localized prostate cancer. DESIGN: Cancer grade, patient age, and comorbidities are considered in a Markov model with Monte Carlo sensitivity analyses. Large and recent pooled analyses and patient-derived utilities are included. RESULTS: Principal findings suggest benefit for radical prostatectomy relative to watchful waiting for men under 70 years of age with low to moderate comorbidity. Men older than 70 with high comorbidity and disease of low to moderate grade do better with watchful waiting. CONCLUSIONS: Cohort-level sensitivity analyses suggest a quality-adjusted treatment benefit for radical prostatectomy for younger men and treatment harm for older men. Tailored patient and clinician decisions remain necessary, especially for men older than 70 in good health but with aggressive cancers.

Original languageEnglish (US)
Pages (from-to)299-305
Number of pages7
JournalJournal of General Internal Medicine
Volume12
Issue number5
DOIs
StatePublished - 1997

Keywords

  • decision analysis
  • patient-derived utilities
  • prostate cancer
  • radical prostatectomy
  • watchful waiting

ASJC Scopus subject areas

  • Internal Medicine

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