Analysis of urological procedures in men who died from prostate cancer using a population-based approach

Kara Babaian, Matthew Truong, Jeremy Cetnar, Deanna S. Cross, Fangfang Shi, Mark A. Ritter, David F. Jarrard

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

What's known on the subject? and What does the study add? Very few studies have examined end-of-life urological studies in men with prostate cancer. These studies reported fewer procedures in men who received primary therapy for prostate cancer. However, these studies were typically single institution or had a short follow-up period. The present study is the first population-based study examining end-of-life urological procedures and uses a geographic region encompassing 385 000 patients. Furthermore, this study incorporates both hospital- and office-based procedures. This approach has not been previously undertaken. Objective To determine using a population-based approach whether men with end-stage prostate cancer who had definitive primary therapy might require fewer urological interventions. Repeated urological procedures can impact health-related quality of life in patients dying from prostate cancer. Patients and methods Using the Marshfield Epidemiological Study Area (MESA) database and tumour registry, we compared end-of-life interventions in men who died from prostate cancer between 1991 and 2009. Patient charts were queried for urological procedures using International Classification of Disease Modification, 9th edition (ICD9) codes for 3 years before death. Clinicopathological information was examined including whether the patient had a history of primary therapy (radiation or radical prostatectomy). Results Among 280 patients dying from prostate cancer, 52 (19%) required 153 urological procedures during the last 3 years of life. The frequency of procedures increased closer to death. The most common procedures involved nephrostomy tube (56%), Foley catheter (24%) and transurethral resection of the prostate (10%). Clinicopathological features did not predict the need for an end-of-life urological procedure. There was no difference in the frequency of upper or lower tract procedures in surgery or radiation patients compared with patients without primary therapy (P= 0.556 and P= 0.508). Using a Kaplan-Meier analysis, there were no differences between groups in the proportion of patients not requiring a procedure (n= 280; P= 0.179). Conclusions This is the first population-based study to examine the frequency of urological procedures in patients with end-stage prostate cancer. A minority of patients (19%) required urological procedures during the final 3 years of life. A history of surgery or radiation did not influence the overall risk for urological intervention.

Original languageEnglish (US)
JournalBJU International
Volume111
Issue number3 B
DOIs
StatePublished - Mar 2013
Externally publishedYes

Fingerprint

Prostatic Neoplasms
Population
Radiation
Transurethral Resection of Prostate
Kaplan-Meier Estimate
International Classification of Diseases
Prostatectomy
Registries
Epidemiologic Studies
Radiotherapy
Therapeutics
Catheters
Quality of Life
Databases

Keywords

  • complications
  • health-related quality of life
  • prostate cancer
  • urological surgical procedures
  • watchful waiting

ASJC Scopus subject areas

  • Urology

Cite this

Analysis of urological procedures in men who died from prostate cancer using a population-based approach. / Babaian, Kara; Truong, Matthew; Cetnar, Jeremy; Cross, Deanna S.; Shi, Fangfang; Ritter, Mark A.; Jarrard, David F.

In: BJU International, Vol. 111, No. 3 B, 03.2013.

Research output: Contribution to journalArticle

Babaian, Kara ; Truong, Matthew ; Cetnar, Jeremy ; Cross, Deanna S. ; Shi, Fangfang ; Ritter, Mark A. ; Jarrard, David F. / Analysis of urological procedures in men who died from prostate cancer using a population-based approach. In: BJU International. 2013 ; Vol. 111, No. 3 B.
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abstract = "What's known on the subject? and What does the study add? Very few studies have examined end-of-life urological studies in men with prostate cancer. These studies reported fewer procedures in men who received primary therapy for prostate cancer. However, these studies were typically single institution or had a short follow-up period. The present study is the first population-based study examining end-of-life urological procedures and uses a geographic region encompassing 385 000 patients. Furthermore, this study incorporates both hospital- and office-based procedures. This approach has not been previously undertaken. Objective To determine using a population-based approach whether men with end-stage prostate cancer who had definitive primary therapy might require fewer urological interventions. Repeated urological procedures can impact health-related quality of life in patients dying from prostate cancer. Patients and methods Using the Marshfield Epidemiological Study Area (MESA) database and tumour registry, we compared end-of-life interventions in men who died from prostate cancer between 1991 and 2009. Patient charts were queried for urological procedures using International Classification of Disease Modification, 9th edition (ICD9) codes for 3 years before death. Clinicopathological information was examined including whether the patient had a history of primary therapy (radiation or radical prostatectomy). Results Among 280 patients dying from prostate cancer, 52 (19{\%}) required 153 urological procedures during the last 3 years of life. The frequency of procedures increased closer to death. The most common procedures involved nephrostomy tube (56{\%}), Foley catheter (24{\%}) and transurethral resection of the prostate (10{\%}). Clinicopathological features did not predict the need for an end-of-life urological procedure. There was no difference in the frequency of upper or lower tract procedures in surgery or radiation patients compared with patients without primary therapy (P= 0.556 and P= 0.508). Using a Kaplan-Meier analysis, there were no differences between groups in the proportion of patients not requiring a procedure (n= 280; P= 0.179). Conclusions This is the first population-based study to examine the frequency of urological procedures in patients with end-stage prostate cancer. A minority of patients (19{\%}) required urological procedures during the final 3 years of life. A history of surgery or radiation did not influence the overall risk for urological intervention.",
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AU - Jarrard, David F.

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N2 - What's known on the subject? and What does the study add? Very few studies have examined end-of-life urological studies in men with prostate cancer. These studies reported fewer procedures in men who received primary therapy for prostate cancer. However, these studies were typically single institution or had a short follow-up period. The present study is the first population-based study examining end-of-life urological procedures and uses a geographic region encompassing 385 000 patients. Furthermore, this study incorporates both hospital- and office-based procedures. This approach has not been previously undertaken. Objective To determine using a population-based approach whether men with end-stage prostate cancer who had definitive primary therapy might require fewer urological interventions. Repeated urological procedures can impact health-related quality of life in patients dying from prostate cancer. Patients and methods Using the Marshfield Epidemiological Study Area (MESA) database and tumour registry, we compared end-of-life interventions in men who died from prostate cancer between 1991 and 2009. Patient charts were queried for urological procedures using International Classification of Disease Modification, 9th edition (ICD9) codes for 3 years before death. Clinicopathological information was examined including whether the patient had a history of primary therapy (radiation or radical prostatectomy). Results Among 280 patients dying from prostate cancer, 52 (19%) required 153 urological procedures during the last 3 years of life. The frequency of procedures increased closer to death. The most common procedures involved nephrostomy tube (56%), Foley catheter (24%) and transurethral resection of the prostate (10%). Clinicopathological features did not predict the need for an end-of-life urological procedure. There was no difference in the frequency of upper or lower tract procedures in surgery or radiation patients compared with patients without primary therapy (P= 0.556 and P= 0.508). Using a Kaplan-Meier analysis, there were no differences between groups in the proportion of patients not requiring a procedure (n= 280; P= 0.179). Conclusions This is the first population-based study to examine the frequency of urological procedures in patients with end-stage prostate cancer. A minority of patients (19%) required urological procedures during the final 3 years of life. A history of surgery or radiation did not influence the overall risk for urological intervention.

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