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dc.contributor.authorParry, MG
dc.contributor.authorCowling, TE
dc.contributor.authorSujenthiran, A
dc.contributor.authorNossiter, J
dc.contributor.authorBerry, B
dc.contributor.authorCathcart, P
dc.contributor.authorAggarwal, A
dc.contributor.authorPayne, H
dc.contributor.authorvan der Meulen, J
dc.contributor.authorClarke, NW
dc.contributor.authorGnanapragasam, VJ
dc.date.accessioned2020-04-16T23:30:23Z
dc.date.available2020-04-16T23:30:23Z
dc.date.issued2020-05-28
dc.identifier.issn1741-7015
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/304433
dc.description.abstractBACKGROUND: The five-tiered Cambridge Prognostic Group (CPG) classification is a better predictor of prostate cancer-specific mortality than the traditional three-tiered classification (low, intermediate, and high risk). We investigated radical treatment rates according to CPG in men diagnosed with non-metastatic prostate cancer in England between 2014 and 2017. METHODS: Patients diagnosed with non-metastatic prostate cancer were identified from the National Prostate Cancer Audit database. Men were risk stratified according to the CPG classification. Risk ratios (RR) were estimated for undergoing radical treatment according to CPG and for receiving radiotherapy for those treated radically. Funnel plots were used to display variation in radical treatment rates across hospitals. RESULTS: A total of 61,999 men were included with 10,963 (17.7%) in CPG1 (lowest risk group), 13,588 (21.9%) in CPG2, 9452 (15.2%) in CPG3, 12,831 (20.7%) in CPG4, and 15,165 (24.5%) in CPG5 (highest risk group). The proportion of men receiving radical treatment increased from 11.3% in CPG1 to 78.8% in CGP4, and 73.3% in CPG5. Men in CPG3 were more likely to receive radical treatment than men in CPG2 (66.3% versus 48.4%; adjusted RR 1.44; 95% CI 1.36-1.53; P < 0.001). Radically treated men in CPG3 were also more likely to receive radiotherapy than men in CPG2 (59.2% versus 43.9%; adjusted RR, 1.18; 95% CI 1.10-1.26). Although radical treatment rates were similar in CPG4 and CPG5 (78.8% versus 73.3%; adjusted RR 1.01; 95% CI 0.98-1.04), more men in CPG5 had radiotherapy than men in CPG4 (79.9% versus 59.1%, adjusted RR 1.26; 95% CI 1.12-1.40). CONCLUSIONS: The CPG classification distributes men in five risk groups that are about equal in size. It reveals differences in treatment practices in men with intermediate-risk disease (CPG2 and CPG3) and in men with high-risk disease (CPG4 and CPGP5) that are not visible when using the traditional three-tiered risk classification.
dc.description.sponsorshipHealthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme, and funded by NHS England and the Welsh Government
dc.format.mediumElectronic
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.rightsAll rights reserved
dc.subjectHumans
dc.subjectProstatic Neoplasms
dc.subjectPrognosis
dc.subjectRisk Factors
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectMale
dc.titleRisk stratification for prostate cancer management: value of the Cambridge Prognostic Group classification for assessing treatment allocation.
dc.typeArticle
prism.issueIdentifier1
prism.publicationDate2020
prism.publicationNameBMC Med
prism.startingPage114
prism.volume18
dc.identifier.doi10.17863/CAM.51513
dcterms.dateAccepted2020-04-07
rioxxterms.versionofrecord10.1186/s12916-020-01588-9
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2020-05-28
dc.contributor.orcidGnanapragasam, Vincent [0000-0003-4722-4207]
dc.identifier.eissn1741-7015
rioxxterms.typeJournal Article/Review
cam.issuedOnline2020-05-28
cam.orpheus.successTue Feb 01 18:59:30 GMT 2022 - Embargo updated
cam.orpheus.counter6
rioxxterms.freetoread.startdate2020-05-28


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