MP12-08 PATIENT NAVIGATION AND ITS ASSOCIATION WITH TREATMENT SELECTION FOR LOW-RISK PROSTATE CANCER

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I1 Apr 2018MP12-08 PATIENT NAVIGATION AND ITS ASSOCIATION WITH TREATMENT SELECTION FOR LOW-RISK PROSTATE CANCER Emily C. Serrell, Moritz Hansen, Andrew Perry, Melanie Feinberg, Tracy Robbins, Scot Remick, Lisa Beaule, Tom Kinkead, Paul K.J. Han, and Jesse D. Sammon Emily C. SerrellEmily C. Serrell More articles by this author , Moritz HansenMoritz Hansen More articles by this author , Andrew PerryAndrew Perry More articles by this author , Melanie FeinbergMelanie Feinberg More articles by this author , Tracy RobbinsTracy Robbins More articles by this author , Scot RemickScot Remick More articles by this author , Lisa BeauleLisa Beaule More articles by this author , Tom KinkeadTom Kinkead More articles by this author , Paul K.J. HanPaul K.J. Han More articles by this author , and Jesse D. SammonJesse D. Sammon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.395AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patient navigation has many theoretical and reported benefits in cancer care. In 2008 our multi-institution health system developed a navigation program to promote shared decision-making for treatment of prostate cancer. This was facilitated by an oncology nurse who educated patients and practiced independent of but in coordination with urology and radiation oncology. We hypothesized that navigation would increase utilization of active surveillance in men with low-risk disease. METHODS Data from 2009-2015 were collected from our multi-institutional tumor registry. Patients with unknown staging were excluded. A subset of patients with National Comprehensive Cancer Network (NCCN) very-low/ low-risk disease were extracted. Multivariable logistic regression analyses were performed to determine factors associated with initial treatment type, controlling for disease and patient characteristics. RESULTS Data from 1,533 patients with prostate cancer in 2009-2015 were reviewed, and 454 men had very-low or low-risk disease. In this group active surveillance increased from 20% in 2009 to 68% in 2015 (Figure). Following adjustment, patients were significantly more likely to choose active surveillance if they were navigated, treated later, treated by a low-volume surgeon, or never married (Table). Navigation was independently associated with active surveillance (Odds Ratio=8.0, 95% Confidence Interval 3.2-19.7). CONCLUSIONS Active surveillance as initial treatment for men with low-risk prostate cancer increased over the study period. Patient navigation was significantly associated with active surveillance. This may reflect increased decision support provided by the clinical patient navigator, who acts as an independent entity to facilitate consults between multiple disciplines, educate patients based on NCCN guidelines, and focus on shared decision making in treatment discussions. With this support, navigation may help to increase active surveillance for low-risk disease. More research is necessary to evaluate other outcomes. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e138 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Emily C. Serrell More articles by this author Moritz Hansen More articles by this author Andrew Perry More articles by this author Melanie Feinberg More articles by this author Tracy Robbins More articles by this author Scot Remick More articles by this author Lisa Beaule More articles by this author Tom Kinkead More articles by this author Paul K.J. Han More articles by this author Jesse D. Sammon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...