MP15-04 VARIATION IN ACTIVE SURVEILLANCE FOLLOW-UP OVER TWO YEARS IN DIVERSE UROLOGY PRACTICES

INTRODUCTION AND OBJECTIVES: Little is known about longitudinal follow-up patterns for men on active surveillance (AS) for prostate cancer (CaP) or how this compares with guideline recommendations. In this context, we examined the rates of conversion to secondary therapy, and the frequency of follow-up PSA tests and prostate biopsy among men managed with AS in the diverse academic and community urology practices comprising the Michigan Urological Surgery Improvement Collaborative (MUSIC). METHODS: MUSIC is a consortium of 42 urology practices that maintains a prospective clinical registry with detailed and validated clinical data for all patients diagnosed with CaP. For this analysis, we identified all patients that entered AS and had at least two years of follow-up in the same practice. We first determined the percentage of patients who transitioned to secondary therapies. Next, we calculated the proportion of AS patients who received the minimum suggested 2year follow-up based on NCCN recommendations: at least 3 PSA tests and one repeat biopsy. We then compared the proportion of patients receiving recommendation concordant AS follow-up at the participating sites. RESULTS: We identified 513 patients that entered AS in MUSIC practices from 1/2012 to 9/2013. The median age of the cohort was 66, median PSA was 5.3 ng/mL (IQR 4.1-7.5 ng/mL), 75% of patients had Gleason 6 disease. Across the entire cohort, 15.6% transitioned to a secondary-treatment before reaching 2 years of follow-up (median time to treatment 1⁄4 13.4 months), with 63% of these patients undergoing prostatectomy. At a practice level, rates of treatment varied widely ranging from 0 to 33% (p1⁄40.002). Overall, 20.2% of patients entering AS received guideline-concordant PSA and biopsy surveillance over 2 years of follow-up; however, this proportion varied widely across MUSIC practices, ranging from 9.1% to 55.1% (p