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Wilt TJ, Shamliyan T, Taylor B, et al. Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Feb. (Comparative Effectiveness Reviews, No. 13.)

Please see 2014 update

Cover of Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer

Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer [Internet].

Contents

Appendix CEvidence Tables and Figures

Table C1. Disease specific mortality or survival for randomized controlled trials

Table C2. Biochemical progression/reoccurrence or bNED for randomized controlled trials

Table C3. Definitions of biochemical progression/reoccurrence or bNED for randomized controlled trials

Table C4. Incidence of distant metastatic disease for randomized controlled trials

Table C5. Definitions of toxicity for randomized controlled trials

Table C6. Intra-operative outcomes and positive margins after laparoscopic vs. open retropubic radical prostatectomy

Table C7. Complication counts

Table C8. Outcomes after cryosurgical prostatectomy in patients with localized prostate cancer

Table C9. Patient outcomes after cryosurgical treatment of localized prostate cancer (evidence from nonrandomized clinical trials and case series)

Table C10. Comparative effectiveness of extraperitoneal versus transperitoneal laparoscopic prostatectomy in patients with localized prostate cancer (adapted from the systematic review by Rassweiler et al)

Table C11. Comparative effectiveness of laparoscopic versus retropubic radical prostatectomy (adapted from the systematic review by Rassweiler et al)

Table C12. Comparative effectiveness of laparoscopic, retropubic, and perineal radical prostatectomy (adapted from the systematic review by Rassweiler et al)

Table C13. Perioperative and pathological parameters and complication rates after three surgical treatments of prostate cancer: robotic assisted, laparoscopic, and open radical retropubic prostatectomy, pooled estimated from 24 observations

Table C14. Outcomes after laparoscopic extraperitoneal, transperitoneal, robot assisted, and radical retropubic prostatectomy (from systematic review by Tooher et al)

Table C15. Comparative effectiveness of robotic assisted laparoscopic radical prostatectomy

Table C16. Comparison of task performance of AESOP (N=10) and EndoAssist (N=10) during operative steps of laparoscopic radical prostatectomy

Table C17. Clinical outcomes after IMRT in patients with localized prostate cancer

Table C18. Acute toxicity outcomes after intensity modulated radiotherapy for prostate cancer

Table C19. Late toxicity outcomes after intensity modulated radiotherapy for prostate cancer

Table C20. Patient outcomes after high-intensity focused ultrasound therapy for localized prostate cancer

Table C21. Proton radiation for localized prostate cancer

Table C22. PCOS: Reason for condition specific bother for responders reporting bother on urinary, bowel, and sexual questions* (Potosky, 2004)

Table C23. Adjusted percentage distributions for satisfaction by characteristics at 24 months* (Hoffman, 2003)

Table C24. Association of bowel, urinary, and sexual function with patients' perception of the problem and satisfaction at 24 months post diagnosis*

Table C25. QOL studies of treatments for localized prostate cancer in nonRCTs

Table C26. QOL studies of treatments for localized prostate cancer in RCTs

Table C27. Quality (% of maximum possible) of studies that assessed the association between patient outcomes and provider volumes

Table C28. Quality of the studies (% of maximum possible) by sponsorship, journal of publication, data sources, and country of publication (means ± standard deviations)

Table C29. Geographic variations in prostate cancer screening, incidence, and mortality

Table C30. Geographic variations in prostate cancer treatments

Table C31. Association between hospital volumes (radical prostatectomy) and surgery related mortality

Table C32. Association between hospital volumes (radical prostatectomy) and complications (cardiac, respiratory or vascular events, the need for reoperation, bleeding, renal failure, and shock)

Table C33. Association between hospital volumes (radical prostatectomy) and quality measures (cancer control, late urinary complications, or long term incontinence, operative quality)

Table C34. Association between hospital volumes (radical prostatectomy) and length of stay in the hospital

Table C35. Association between hospital status and outcomes

Table C36. Association between surgeon volumes (radical prostatectomy) and surgery related mortality

Table C37. Association between surgeon volumes (radical prostatectomy) and complications (cardiac, respiratory or vascular events, the need for reoperation, bleeding, renal failure, and shock)

Table C38. Association between surgeon volumes (radical prostatectomy) and quality measures (late urinary complications or long term incontinence and operative quality)

Table C39. Association between surgeon volumes (radical prostatectomy) and length of stay in the hospital

Table C40. Sampling sources of studies that evaluated associations between providers' volumes (radical prostatectomy) and patients' outcomes

Table C41. Sampling sources of studies that evaluated associations between provider's locations and patient outcomes

Table C42. Studies that evaluated association between other provider's factors (specialty, facility structure, awareness) and patient outcomes (no overlapping in samples detected)

Table C43. Association between physician specialty and patient outcomes

Table C44. Variability in management of prostate cancer (compared with recommended guidelines)

Table C45. Association between provider characteristics and patient outcomes

Table C46. Association between physician characteristics and learning curves for treatment of prostate cancer

Table C47. Distribution of urologists and radiation oncologists in the United States*

Table C48. Significant geographic differences in total numbers of urologists

Table C49. Significant geographic differences in total numbers of radiation oncologists

Table C50. Significant geographic differences in % of males >40 years of age who had PSA test during last 2 years

Table C51. Significant geographic differences in % of males who ever had PSA test

Table C52. Incidence of prostate cancer in the U.S. regions reported in individual studies

Table C53. Regional variations in age-standardized prostate cancer incidence/100,000 male population (CDC data, 1999-2004) (pair-wise comparisons between U.S. Census regions)

Table C54. Significant geographic differences in incidence of prostate cancer among differences races (CDC data, 1999-2004) (pair-wise comparisons between the US Census regions)

Table C55. Incidence of localized prostate cancer reported in individual studies

Table C56. Correlation between incidence, mortality, and physicians' distribution in geographic regions (state level)

Table C57. Correlation between incidence and mortality in different races in geographic regions (state level) (CDC data)

Table C58. Correlation between incidence, mortality, and screening in geographic regions (state level) (CDC data)

Table C59. Proportion of patients treated with external beam therapy, brachytherapy, primary androgen deprivation therapy, radiation, and watchful waiting (%) pooled analysis

Table C60. Correlation between proportion of patients with different primary treatments and total number of urologists and radiation oncologists in geographic regions (state level)

Table C61. Significant variations in proportion of patients treated with external beam therapy

Table C62. Significant variations in proportion of patients treated with watchful waiting

Table C63. Significant variations in proportion of patients treated with brachytherapy

Table C64. Significant variations in proportion of patients treated with primary androgen deprivation

Table C65. Significant variations in proportion of patients treated with radical prostatectomy

Table C66. Geographic variations in radical prostatectomy. Age adjusted Rate/100,000 male population (pooled analysis)

Table C67. Significant differences in age adjusted rate/100,000 male population (pooled analysis)

Table C68. Differences in utilization of radical prostatectomy compared with the national average (pooled analysis)

Table C69. Length of hospital stay after radical prostatectomy

Table C70. Cost of radical prostatectomy in $ U.S

Table C71. Differences in hospital charges for radical prostatectomy in U.S, regions

Table C72. Age adjusted mortality from prostate cancer per 100,000 male population in U.S. regions reported in individual studies

Table C73. Geographic differences in prostate cancer age adjusted mortality per100,000 male population (CDC data, 1999-2004)

Table C74. Significant geographic differences in prostate cancer age adjusted mortality/100,000 among different races (CDC data, 1999-2004)

Table C75. Distribution of hospital and surgeon annual volumes of radical prostatectomy

Table C76. Odds ratio and attributable events of clinical outcomes after different treatments I patients with localized prostate cancer

Table C77. Comparative effectiveness of adverse events after different treatments in patients with localized prostate cancer

Table C78. Odds ratio of outcomes, attributable proportion of events among exposed, number needed to treat to harm one patient, and the number of avoided events per 1000 treated patients: radical prostatectomy vs. watchful waiting

Figure C1. Flow of articles reviewed

Figure C2. Disease-specific survival at time points by treatment

Figure C3. Comparative studies of LRP vs. RRP; operative data (from the systematic review of nonrandomized clinical trials and case series by Rassweiler et al)

Figure C4. Comparative studies of transperitoneal vs. extraperitoneal radical prostatectomy; operative data (from the systematic review of nonrandomized clinical trials and case series by Rassweiler et al)

Figure C5. Quality of life measures after IMRT vs. 3D-CRT} (Kupelian, 2002)

Figure C6. Search strategy

Figure C7. Percentage of responses by family physicians and general internists to the question: “Do you recommend the following for prostate cancer screening for patients 50 years old and older?” (Kim, 2002)

Figure C8. Percentage of responses by urologists and primary care physicians to the question “Which test do you believe is the single best screening tool? Do you screen for prostate cancer patients older than 79 years? Do you screen young asymptomatic patients?” (McKnight, 1996)

Figure C9. Percentage of responses by urologists and radiation oncologists to the question: “Do you recommend that primary care physicians include PSA testing as a part of the routine physician examinations for men who are at average risk of prostate cancer in each age category?” (Fowler, 2000)

Figure C10. Percentage of responses by urologists and primary care physicians to the question whether radical prostatectomy or external beam radiation “probably” or “definitely” offers survival benefit for patients with clinically localized prostate cancer (Fowler, 1998)

Figure C11. Which therapy offers the best survival to patients with clinically localized prostate cancer? Treatment recommendations by urologists and radiation oncologists (Fowler, 2000)

Figure C12. Percentage of responses by urologists and radiation oncologists to the question whether they believed that three main potentially curative prostate cancer therapies are overused or underused in the United States (Fowler, 2000)

Figure C13. Distribution of urologists* in the U.S. regions (pooled analysis from 1999-2004)

Figure C14. Distribution of radiation oncologists* in U.S. regions

Figure C15. Ratio* of urologists (1999-2004) per 100,000 adult population (2002) in U.S. regions

Figure C16. Ratio* of radiation oncologists (1999-2004) per 100,000 adult population (2002) in U.S. regions

Figure C17. Geographic variations in PSA testing*

Figure C18. Geographic differences in PSA testing in U.S. regions*

Figure C19. Geographic variations in age adjusted incidence of prostate cancer per 100,000 male population (pooled analysis from 4 studies and CDC data)

Figure C20. Incidence of prostate cancer (per 100,000 male population) in U.S. regions (CDC data, 1999-2004) (U.S. Cancer Statistics Working Group, 2005)

Figure C21. Percentage of patients with prostate cancer treated with external beam radiation as an initial therapy in the U.S. regions (pooled analysis)

Figure C22. Percentage of patients with prostate cancer treated with radiation as an initial therapy in U.S. regions (pooled analysis)

Figure C23. Percentage of patients with localized prostate cancer treated with watchful waiting as an initial therapy in U.S. regions (pooled analysis)

Figure C24. Percentage of patients with prostate cancer treated with brachytherapy as an initial therapy in U.S. regions (pooled analysis)

Figure C25. Percentage of patients with prostate cancer treated with primary androgen deprivation as an initial therapy in U.S. regions (pooled analysis)

Figure C26. Relative risk of primary androgen deprivation as an initial therapy (polled analysis)

Figure C27. Percentage of patients with localized prostate cancer treated with radical prostatectomy as an initial therapy in the U.S. regions (pooled analysis)

Figure C28. Age adjusted rate of radical prostatectomy per 100,000 male population (results from individual studies)

Figure C29. Length of stay in hospital after radical prostatectomy in U.S. regions (pooled analysis)

Figure C30. Hospital charges for radical prostatectomy in U.S. regions (results from one study)

Figure C31. Mortality from prostate cancer (per 100,000 male population) among different races in U.S. regions (CDC data, 1999-2004)

Figure C32. Positive correlation between PSA testing among males older than 40 years and adjusted prostate cancer mortality in the USA. Ecologic analysis

Figure C33. Difference in surgery-related death rate corresponding to an increase by 10 radical prostatectomies performed in hospital

Figure C34. Relative risk of surgery related death corresponding to an increase by 10 radical prostatectomies performed in hospital

Figure C35. Relative risk of surgery related death in quartile and above and below mean of annual hospital volume (pooled analysis)

Figure C36. Number of avoided and excessive deaths in quartiles and above and below mean of annual hospital volume (pooled analysis)

Figure C37. Difference in surgery related complications rate corresponding to an increase by 10 radical prostatectomies performed in hospital

Figure C38. Relative risk of adjuvant therapy 6 months after radical prostatectomy in relation to hospital volume (results from one cohort study)

Figure C39. Difference in surgery related complication rates corresponding to an increase by 10 radical prostatectomies performed in hospital

Figure C40. Difference in length of stay and readmission rate corresponding to an increase by 10 procedures in annual hospital volume (results from individual studies)

Figure C41. Difference in length of stay and readmission rate corresponding to an increase by ten procedures in annual hospital volume (pooled analysis)

Figure C42. Difference in length of stay and readmission rate in categories of hospital volume (pooled analysis)

Figure C43. Difference in rates of surgery-related urinary complications, long term incontinence, and positive surgical margins corresponding to an increase by one radical prostatectomy performed by a surgeon (the results from individual studies)

Figure C44. Disease-specific survival at time points by treatment and PSA level (ng/ml)

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Wilt TJ, Shamliyan T, Taylor B, et al. Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Feb. (Comparative Effectiveness Reviews, No. 13.) Appendix C, Evidence Tables and Figures.
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