GENERAL INFORMATION

 

Participation

The Prostate Cancer Outcomes Registry – Australia and New Zealand (PCOR-ANZ) is an important initiative to monitor and benchmark the quality of treatment and care of men diagnosed with prostate cancer across Australia and New Zealand. To participate please contact your jurisdiction Registry Coordinator here. If you would like to view the hospitals currently participating in PCOR-ANZ, please visit the Participating Sites tab.

The  jurisdiction Registry Coordinator will liaise with the hospital’s Human Research Ethics Committee to submit an ethics application for participation. Each hospital should identify an appropriate lead clinician (for example, the Head of Urology or Radiation Oncology departments) who will be responsible for ensuring that hospital staff makes data available to data collectors. We ask you to encourage clinicians at your hospital to participate.

Once a notification of an eligible participant is received, registry staff will send a Patient Explanatory Statement and a letter of invitation to participate in PCOR-ANZ to men newly diagnosed with prostate cancer. Men who consent to participate in the registry have provided consent for their personal and clinical information to be collected and made available to PCOR-ANZ.

Data Collectors will visit the hospital to collect and input relevant personal and clinical details of the participant into the database at times agreed to with medical personnel.

benefits of participating

Data collected for PCOR-ANZ has many significant impacts in research, development, and education. It has the ability to:

  • Provide a cross-sectional view of clinical and demographic aspects of prostate cancer that may be studied in detail using targeted, prospective study design or using health statistics.
  • Identify whether clinicians are managing the disease in line with evidence-based practice.
  • Collect up-to-date information about patterns of care and enables oversight of changing patterns of disease demographic and management.
  • Enable clinicians to compare their own patient population and therapeutic management with that of other clinicians (Note: no clinician identifying information will be released by PCOR-ANZ).
  • Be used to assist in the design of clinical trials, including identifying questions for study.
  • Provide clinicians and institutions with mortality and morbidity data associated with various risk and treatment groups, both for their own patients and the wider cohort of men with prostate cancer.
  • Be used as an educational tool for clinicians and students.

PCOR USER DOCUMENTS


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MEASURING QUALITY OF CARE

Quality of care may be measured by assessing structure, process and outcome of care.

PCOR-ANZ collects the below listed clinical quality indicators to assess quality of care. For detailed information, please refer to our 2016 publication in European Urology Focus entitled Development of Indicators to Assess Quality of Care for Prostate Cancer“.

Indicator Rationale
STRUCTURE
Number of patients treated at institution per year (by treatment). Patients treated in high volume hospitals have shorter hospital stay, fewer complications, lower readmission rates, and higher mortality than patients treated in low volume hospitals 1.
PROCESS
Positive margin rate post RP. The presence of a positive margin increases the risk of biochemical recurrence, local recurrence and the need for salvage treatment 2
PSA level recorded at diagnosis. Without a PSA it is difficult to accurately identify appropriate treatment and to calculate risk of disease progression.
Documentation of clinical T stage in the medical record. The clinical stage provides the best initial estimate of the extent of disease. The clinical stage is based on the results of the physical examination (including DRE), biochemical tests, prostate biopsy, endoscopy and any imaging tests 3
Active surveillance/watchful waiting for men with low risk disease. Men with low-risk localised prostate cancer, for whom RP and RT is suitable, should be offered active surveillance as an option 4.
Evidence that patients in high-risk disease group received active treatment. Men with high-risk localised prostate cancer should not be offered active surveillance 4.
Time from biopsy-confirmed diagnosis to first treatment Significant increases in the proportion of adverse pathological outcomes were found beyond 75 days overall, 150 days for patients with Gleason ≤6, and PSA 0-10, 60 days for patients with Gleason 7 and PSA >20, and 30 days for patients with Gleason 8-10 and PSA 11-20 5.
OUTCOMES
5-, 10-year and 15-year overall survival An individual’s prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis.

In Australia, the 5- 10- and 15-year survival rate for men diagnosed with prostate cancer is 92%, 93% and 77% respectively 3.

Clinical and/or biochemical disease-free survival after primary treatment by RT or RP 15–30% of patients treated for prostate cancer, will experience a recurrence 6.

 

Patient assessment of urinary, sexual, and bowel function Urinary function is better post RT and BT than post RP 7.

Sexual function is better post BT than post RT or RP 7.

Bowel function is worse post RT and BT, than post RP 7.

Urinary domain score, classified as 0 to 49 severe, 50 to 69 moderate and 70 to 100 mild 8.

Sexual stratification 0-32 (severe), 33-44 (moderate), 45-59 (mild/moderate), 60-74 (mild), 75-100 (none) 8.

Bowel function has not been reported in terms of severity scores.

Patient assessment of urinary, sexual, and bowel bother Urinary and sexual bother is similar post RP, RT and BT 7.

Bowel bother is higher post RT and BT, than post RP 7.

Rate of in-hospital death from surgical complications The risk of postoperative mortality after RP is relatively low for otherwise healthy older men up to age 79 (30)

 

REFERENCES

[1] Barocas DA, Mitchell R, Chang SS, Cookson MS. Impact of surgeon and hospital volume on outcomes of radical prostatectomy. Urol Oncol 2010;28:243–50.

[2] Boorjian SA, Karnes RJ, Crispen PL, et al. The impact of positive surgical margins on mortality following radical prostatectomy during the prostate specific antigen era. J Urol 2010;183:1003–9.

[3] Prostate cancer. Cancer Council Australia Web site. http://www. cancer.org.au/about-cancer/types-of-cancer/prostate-cancer. html. Updated 5 June 2015. Accessed 14 October 2015.

[4] Guidance: prostate cancer. National Institute for Health and Care Excellence Web site. https://www.nice.org.uk/guidance/cg175. Updated 2014. Accessed 14 October 2015.

[5] Berg WT, Danzig MR, Pak JS, et al. Delay from biopsy to radical prostatectomy influences the rate of adverse pathologic outcomes. Prostate 2015;75:1085–91.

[6] Simmons MN, Stephenson AJ, Klein EA. Natural history of biochemical recurrence after radical prostatectomy: risk assessment for secondary therapy. Eur Urol 2007;51:1175–84.

[7] Frank SJ, Pisters LL, Davis J, Lee AK, Bassett R, Kuban DA. An assessment of quality of life following radical prostatectomy, high dose external beam radiation therapy and brachytherapy iodine implantation as monotherapies for localized prostate cancer. J Urol 2007;177:2151–6, discussion 2156.

[8] Ellison JS, He C, Wood DP. Early postoperative urinary and sexual function predicts functional recovery 1 year after prostatectomy. J Urol 2013;190:1233–8.

REGISTERED USERS SECTION (LOCKED)


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