Categorizing Localized Prostate Cancer Patients Based on Initial Active Treatment: A Real-World Evidence Case Study in Finland
Author(s)
Hakkarainen T1, Lahelma M2, Pietilä M3, Hervonen P3, Murtola T4, Kääriäinen O5, Minn H6, Nykopp T5, Ronkainen H7, Ettala O6, Rannikko A8, Pennanen P2
1NHG Finland Oy, Helsinki, 18, Finland, 2NHG Finland Oy, Helsinki, Uusimaa, Finland, 3Janssen-Cilag Oy, Espoo, Uusimaa, Finland, 4Tampere University Hospital, Tampere, Pirkanmaa, Finland, 5Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland, 6Turku University Hospital, Turku, Varsinais-Suomi, Finland, 7Oulu University Hospital, Oulu, Pohjois-Pohjanmaa, Finland, 8University of Helsinki and Helsinki University Hospital, Helsinki, 18, Finland
Presentation Documents
OBJECTIVES: Prostate cancer has significant health and societal impacts, with no clear consensus on the most effective and efficient treatment strategy for localized prostate cancer (LPC)1. To evaluate the economic impacts of different treatment strategies, it is essential to accurately identify these strategies. The aim of this study was to develop a robust method for categorizing LPC patients based on their initial treatment strategy.
METHODS: Pseudonymized data on adult males diagnosed with LPC between July 2010 and June 2021 were collected retrospectively from Finland's five university hospitals and the Social Insurance Institution. In collaboration with Finnish urologists and oncologists, an algorithm was iteratively developed and refined to accurately categorize patients according to their initial treatment strategy. The challenge was to balance clinically accurate definitions with the common data limitations inherent in registry studies, which prevent overly precise definitions.
RESULTS: The final algorithm categorized LPC patients into the following groups based on their first active cancer treatment:
- Radiotherapy with androgen deprivation therapy (RT+ADT): RT as the first radical treatment within 9 months after diagnosis and ADT given before the start of RT.
- Radiotherapy only (RT): RT as the first radical treatment within 9 months after diagnosis and no ADT given before the start of RT.
- Radical Prostatectomy (RP): RP as the first radical treatment within 9 months after diagnosis, with or without ADT.
- No Immediate Treatment (NIT): No active treatments within 9 months after diagnosis.
CONCLUSIONS: Retrospective categorization of LPC patients into different treatment strategies is challenging. The NIT cohort represents mostly active surveillance but also includes watchful waiting, however separating these patients was not possible. The developed algorithm provides a robust framework for categorizing LPC patients based on initial treatment strategies, facilitating further economic and clinical outcome analyses.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 12, S2 (December 2024)
Code
RWD115
Topic
Real World Data & Information Systems, Study Approaches
Topic Subcategory
Electronic Medical & Health Records, Health & Insurance Records Systems, Reproducibility & Replicability
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology