Association of functional status and treatment choice among older men with prostate cancer in the Medicare Advantage population.
Cancer
; 122(20): 3199-3206, 2016 Oct 15.
Article
en En
| MEDLINE
| ID: mdl-27379732
ABSTRACT
BACKGROUND:
There are several effective treatments for prostate cancer. To what extent a patient's functional status influences the treatment decision is unknown. This study examined the association between functional status and treatment among older men with prostate cancer.METHODS:
Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey data were used to identify men who were 65 years old or older and were diagnosed with prostate cancer between 1998 and 2009. The primary outcome was treatment choice conservative management, surgery, or radiation within 1 year of the diagnosis. The exposure was the functional status assessed as 4 measures within 3 domains 1) physical function (activities of daily living [ADLs] and physical component summary score), 2) cognitive function (survey completer self vs proxy), and 3) emotional well-being (mental component summary score). A multivariate, multinomial logistic regression was fitted with adjustments for several patient, tumor, and regional characteristics.RESULTS:
This study identified 508 conservative management patients, 195 surgery patients, and 603 radiation patients. Compared with men with no ADL dependency, those with any ADL dependency had lower odds of receiving surgery (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.38-0.99) or radiation (OR, 0.58; 95% CI, 0.43-0.78) versus conservative management. ADL dependency did not differ when surgery and radiation were compared. Patients with a proxy survey response were less likely to receive surgery or radiation versus conservative management.CONCLUSIONS:
Functional status is associated with treatment choice for men with prostate cancer. Future research should examine whether this is due to physician recommendations, patient preferences, or a combination. Cancer 2016;1223199-206. © 2016 American Cancer Society.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Próstata
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Actividades Cotidianas
/
Conducta de Elección
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Medicare Part C
/
Prioridad del Paciente
Tipo de estudio:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Humans
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Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Cancer
Año:
2016
Tipo del documento:
Article