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Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) for Localized Prostate Cancer

Completed
Conditions
Prostate Cancer
Registration Number
NCT01326286
Lead Sponsor
Vanderbilt University
Brief Summary

This study will primarily compare the effectiveness of surgery and radiation for localized prostate cancer, the most common male cancer. It will focus on modern technologies and control for differences in patients and treatments that may affect both cancer-related and patient-reported outcomes (such as impotence and incontinence). By figuring out what treatments "work best, in which patients and in whose hands", it will help men with prostate cancer make better decisions regarding their care.

Detailed Description

Prostate cancer is the most common solid tumor and the second leading cause of cancer death among American men. While surgery, radiation and observation have all been deemed appropriate for newly diagnosed men, tremendous uncertainty remains regarding the optimal treatment. AHRQ's 2008 evidence report on the comparative effectiveness of therapies for localized prostate cancer concluded that "no one therapy can be considered the preferred treatment for localized prostate cancer due to the limitations in the body of evidence as well as the likely tradeoffs an individual patient must make between estimated treatment effectiveness, necessity and adverse effects." The existing literature is limited by its focus on older therapeutic modalities and failure to control for individual patient characteristics and provider/hospital characteristics that may influence outcomes (quality of care). To fill these evidence gaps, we propose to expand a network of state tumor registries and a national observational disease registry to establish a new population-based cohort of men newly diagnosed with localized prostate cancer. We will prospectively measure key patient-reported outcomes, such as health-related quality of life and side-effects of therapy at diagnosis and 6 and 12 months later. We will also collect detailed medical record information, including clinical data, technical details of the interventions, complications, short-term cancer recurrence rates, and quality-of-care indicators.

By using this approach, we will overcome limitations of the extant literature and achieve the following specific aims:

1. To compare the effectiveness of contemporary surgical and radiation techniques for localized prostate cancer in the cohort described above in terms of the 6- and 12-month patient-reported outcomes, side-effects and complications of treatment.

2. To identify patient level characteristics that may influence comparative effectiveness.

3. To assess how the comparative effectiveness of the various therapies varies by quality of care received.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
3265
Inclusion Criteria
  • Pathologic diagnosis of adenocarcinoma of the prostate
  • Clinically localized stage
  • PSA <50ng/ml
  • age 18-79
Exclusion Criteria
  • diagnosis of other malignancy (excluding squamous or basal cell carcinoma of the skin) within 3 years of diagnosis of prostate cancer
  • age 80 or greater
  • clinically locally advanced or metastatic disease
  • PSA equal to or greater than 50 ng/ml
  • pathologic diagnosis of prostate cancer greater than 6 months prior to baseline recruitment interview

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Disease-Specific Health-Related Quality of Life (EPIC)12, 24 and 60 months after enrollment

Sexual, urinary, bowel and hormonal function and bother subscores will be assessed

Secondary Outcome Measures
NameTimeMethod
General Health-Related Quality of Life (SF-12)6- and 12-months after enrollment
Complications of treatment6- and 12-months after enrollment

data collected from patient report and medical record review

cancer-free survival6 and 12 months after enrollment

assessed using PSA levels obtained from medical record review

Trial Locations

Locations (5)

University of Southern California

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Los Angeles, California, United States

Emory University

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Atlanta, Georgia, United States

Lousiana State University Health Sciences Center- New Orleans

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New Orleans, Louisiana, United States

Cancer Institute of New Jersey

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New Brunswick, New Jersey, United States

University of California, San Francisco

๐Ÿ‡บ๐Ÿ‡ธ

San Francisco, California, United States

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