Key clinical point: Cumulative androgen deprivation therapy (ADT) is associated with a significant risk for dementia in older men with prostate cancer.

Major finding: At a median follow-up of 7 years, 2.3% of patients were diagnosed with dementia. Cumulative ADT use showed a significant association with dementia (hazard ratio [HR], 2.02; P < .01). No significant association was seen between primary treatment type and onset of dementia in the patients who did not receive ADT (HR, 1.4; P = .14).

Study details: A retrospective study of 13,570 patients aged ≥50 years from the CaPSURE registry diagnosed with prostate cancer between 1995 and 2017.

Disclosures: This study was supported by the UCSF Goldberg-Benioff Program in Translational Cancer Biology. The authors reported no competing interests.

Source: Lonergan PE et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002335.

Key clinical point: Cumulative androgen deprivation therapy (ADT) is associated with a significant risk for dementia in older men with prostate cancer.

Major finding: At a median follow-up of 7 years, 2.3% of patients were diagnosed with dementia. Cumulative ADT use showed a significant association with dementia (hazard ratio [HR], 2.02; P < .01). No significant association was seen between primary treatment type and onset of dementia in the patients who did not receive ADT (HR, 1.4; P = .14).

Study details: A retrospective study of 13,570 patients aged ≥50 years from the CaPSURE registry diagnosed with prostate cancer between 1995 and 2017.

Disclosures: This study was supported by the UCSF Goldberg-Benioff Program in Translational Cancer Biology. The authors reported no competing interests.

Source: Lonergan PE et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002335.

Key clinical point: Cumulative androgen deprivation therapy (ADT) is associated with a significant risk for dementia in older men with prostate cancer.

Major finding: At a median follow-up of 7 years, 2.3% of patients were diagnosed with dementia. Cumulative ADT use showed a significant association with dementia (hazard ratio [HR], 2.02; P < .01). No significant association was seen between primary treatment type and onset of dementia in the patients who did not receive ADT (HR, 1.4; P = .14).

Study details: A retrospective study of 13,570 patients aged ≥50 years from the CaPSURE registry diagnosed with prostate cancer between 1995 and 2017.

Disclosures: This study was supported by the UCSF Goldberg-Benioff Program in Translational Cancer Biology. The authors reported no competing interests.

Source: Lonergan PE et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002335.

Key clinical point: More than 9% of men with prostate cancer undergoing radical prostatectomy report a bad urinary incontinence score. Only approximately 9% of these men receive subsequent incontinence surgery.

Major finding: About 5,165 men completed a posttreatment survey after a median time of 18.6 months. A “bad” urinary incontinence score was reported by 9.3% of patients, and 4% also reported having had a big problem with their urinary function. Only 9.1% of patients with "bad" urinary incontinence scores underwent incontinence surgery within 6 months.

Study details: A retrospective study of 11,290 patients with prostate cancer who underwent radical prostatectomy between April 2014 and January 2016.

Disclosures: This work was supported by National Institute of Health Research, Medical Research Council, University College London Hospitals/University College London Comprehensive Biomedical Research Centre, and others. The authors received honoraria, advisory fees, travel expenses, and/or being employed outside this work.

Source: Parry MG et al. BJU Int. 2021 Nov 30. doi: 10.1111/bju.15663.

Key clinical point: More than 9% of men with prostate cancer undergoing radical prostatectomy report a bad urinary incontinence score. Only approximately 9% of these men receive subsequent incontinence surgery.

Major finding: About 5,165 men completed a posttreatment survey after a median time of 18.6 months. A “bad” urinary incontinence score was reported by 9.3% of patients, and 4% also reported having had a big problem with their urinary function. Only 9.1% of patients with "bad" urinary incontinence scores underwent incontinence surgery within 6 months.

Study details: A retrospective study of 11,290 patients with prostate cancer who underwent radical prostatectomy between April 2014 and January 2016.

Disclosures: This work was supported by National Institute of Health Research, Medical Research Council, University College London Hospitals/University College London Comprehensive Biomedical Research Centre, and others. The authors received honoraria, advisory fees, travel expenses, and/or being employed outside this work.

Source: Parry MG et al. BJU Int. 2021 Nov 30. doi: 10.1111/bju.15663.

Key clinical point: More than 9% of men with prostate cancer undergoing radical prostatectomy report a bad urinary incontinence score. Only approximately 9% of these men receive subsequent incontinence surgery.

Major finding: About 5,165 men completed a posttreatment survey after a median time of 18.6 months. A “bad” urinary incontinence score was reported by 9.3% of patients, and 4% also reported having had a big problem with their urinary function. Only 9.1% of patients with "bad" urinary incontinence scores underwent incontinence surgery within 6 months.

Study details: A retrospective study of 11,290 patients with prostate cancer who underwent radical prostatectomy between April 2014 and January 2016.

Disclosures: This work was supported by National Institute of Health Research, Medical Research Council, University College London Hospitals/University College London Comprehensive Biomedical Research Centre, and others. The authors received honoraria, advisory fees, travel expenses, and/or being employed outside this work.

Source: Parry MG et al. BJU Int. 2021 Nov 30. doi: 10.1111/bju.15663.

Key clinical point: Men with low-grade prostate cancer undergoing delayed radical prostatectomy (RP) after an initial period of active surveillance show a small increase in the use of secondary treatments, despite an increase in adverse pathology vs those undergoing immediate RP.

Major finding: The incidence of adverse pathology was higher with delayed vs immediate RP (49% vs 36%; P < .0001). Estimated 24‐month secondary treatment‐free probabilities in patients who received delayed and immediate RP were 93% and 96%, respectively (P = .0023).

Study details: A retrospective study of 1,878 patients with grade group 1 prostate cancer who underwent RP between April 2012 and July 2018.

Disclosures: This study is supported by the Blue Cross Blue Shield of Michigan Foundation. Some authors reported salary support. No other competing interests were disclosed.

Source: Arcot R et al. Prostate. 2021 Dec 2. doi: 10.1002/pros.24277.

Key clinical point: Men with low-grade prostate cancer undergoing delayed radical prostatectomy (RP) after an initial period of active surveillance show a small increase in the use of secondary treatments, despite an increase in adverse pathology vs those undergoing immediate RP.

Major finding: The incidence of adverse pathology was higher with delayed vs immediate RP (49% vs 36%; P < .0001). Estimated 24‐month secondary treatment‐free probabilities in patients who received delayed and immediate RP were 93% and 96%, respectively (P = .0023).

Study details: A retrospective study of 1,878 patients with grade group 1 prostate cancer who underwent RP between April 2012 and July 2018.

Disclosures: This study is supported by the Blue Cross Blue Shield of Michigan Foundation. Some authors reported salary support. No other competing interests were disclosed.

Source: Arcot R et al. Prostate. 2021 Dec 2. doi: 10.1002/pros.24277.

Key clinical point: Men with low-grade prostate cancer undergoing delayed radical prostatectomy (RP) after an initial period of active surveillance show a small increase in the use of secondary treatments, despite an increase in adverse pathology vs those undergoing immediate RP.

Major finding: The incidence of adverse pathology was higher with delayed vs immediate RP (49% vs 36%; P < .0001). Estimated 24‐month secondary treatment‐free probabilities in patients who received delayed and immediate RP were 93% and 96%, respectively (P = .0023).

Study details: A retrospective study of 1,878 patients with grade group 1 prostate cancer who underwent RP between April 2012 and July 2018.

Disclosures: This study is supported by the Blue Cross Blue Shield of Michigan Foundation. Some authors reported salary support. No other competing interests were disclosed.

Source: Arcot R et al. Prostate. 2021 Dec 2. doi: 10.1002/pros.24277.

Key clinical point: In patients with low-intermediate prostate cancer undergoing active surveillance, Gleason grade group (GG) 2 and positive targeted core are associated with significant risk for upgradation.

Major finding: At a median follow-up of 4.8 years, GG upgraded in 92 patients. GG2 (hazard ratio [HR], 2.93; 95% CI, 1.05-8.19) and 1 and more than 1 positive targeted cores (HR, 2.75; 95% CI, 1.25-6.03 and HR, 3.38; 95% CI, 1.65-6.91, respectively) at confirmatory magnetic resonance imaging (MRI)-guided biopsy were significant risk factor of upgradation.

Study details: A prospective study of 519 men with GG 1 and GG 2 prostate cancer undergoing active surveillance, who received confirmatory targeted and systemic MRI-guided biopsy followed by surveillance MRI-guided biopsy every 12 to 24 months.

Disclosures: This work was supported by National Cancer Institute, Center for Interventional Oncology, University of California, and others. Dr. L.S. Marks and Dr. A. Priester reported association with Avenda Health. No other competing interests were reported.

Source: Kinnaird A et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002343.

Key clinical point: In patients with low-intermediate prostate cancer undergoing active surveillance, Gleason grade group (GG) 2 and positive targeted core are associated with significant risk for upgradation.

Major finding: At a median follow-up of 4.8 years, GG upgraded in 92 patients. GG2 (hazard ratio [HR], 2.93; 95% CI, 1.05-8.19) and 1 and more than 1 positive targeted cores (HR, 2.75; 95% CI, 1.25-6.03 and HR, 3.38; 95% CI, 1.65-6.91, respectively) at confirmatory magnetic resonance imaging (MRI)-guided biopsy were significant risk factor of upgradation.

Study details: A prospective study of 519 men with GG 1 and GG 2 prostate cancer undergoing active surveillance, who received confirmatory targeted and systemic MRI-guided biopsy followed by surveillance MRI-guided biopsy every 12 to 24 months.

Disclosures: This work was supported by National Cancer Institute, Center for Interventional Oncology, University of California, and others. Dr. L.S. Marks and Dr. A. Priester reported association with Avenda Health. No other competing interests were reported.

Source: Kinnaird A et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002343.

Key clinical point: In patients with low-intermediate prostate cancer undergoing active surveillance, Gleason grade group (GG) 2 and positive targeted core are associated with significant risk for upgradation.

Major finding: At a median follow-up of 4.8 years, GG upgraded in 92 patients. GG2 (hazard ratio [HR], 2.93; 95% CI, 1.05-8.19) and 1 and more than 1 positive targeted cores (HR, 2.75; 95% CI, 1.25-6.03 and HR, 3.38; 95% CI, 1.65-6.91, respectively) at confirmatory magnetic resonance imaging (MRI)-guided biopsy were significant risk factor of upgradation.

Study details: A prospective study of 519 men with GG 1 and GG 2 prostate cancer undergoing active surveillance, who received confirmatory targeted and systemic MRI-guided biopsy followed by surveillance MRI-guided biopsy every 12 to 24 months.

Disclosures: This work was supported by National Cancer Institute, Center for Interventional Oncology, University of California, and others. Dr. L.S. Marks and Dr. A. Priester reported association with Avenda Health. No other competing interests were reported.

Source: Kinnaird A et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002343.

Key clinical point: Prostate-specific antigen (PSA)-based prostate cancer screening was associated with less overdiagnosis of low-risk cancer in statin users, with similar risk for advanced disease and mortality compared with nonusers.

Major finding: PSA screening was associated with increased prostate cancer incidence in statin nonusers (rate ratio [RR], 1.31; 95% CI, 1.24-1.38), but not in statin users (RR, 1.02; 95% CI, 0.95-1.10; P for interaction < .001). The screening was not associated with decreased mortality in statin users and nonusers.

Study details: A post hoc analysis of the Finnish Prostate Cancer Screening Trial in which 78,606 men were randomly assigned to either the screening or the control group.

Disclosures: This study was supported by Tampere University Hospital, Finnish Cancer Society, and Academy of Finland. The authors received grants, consulting/speaker/personal fees, research funding, compensation, and/or held patents outside this work.

Source: Vettenranta A et al. JAMA Oncol. 2021 Nov 24. doi: 10.1001/jamaoncol.2021.5672.

Key clinical point: Prostate-specific antigen (PSA)-based prostate cancer screening was associated with less overdiagnosis of low-risk cancer in statin users, with similar risk for advanced disease and mortality compared with nonusers.

Major finding: PSA screening was associated with increased prostate cancer incidence in statin nonusers (rate ratio [RR], 1.31; 95% CI, 1.24-1.38), but not in statin users (RR, 1.02; 95% CI, 0.95-1.10; P for interaction < .001). The screening was not associated with decreased mortality in statin users and nonusers.

Study details: A post hoc analysis of the Finnish Prostate Cancer Screening Trial in which 78,606 men were randomly assigned to either the screening or the control group.

Disclosures: This study was supported by Tampere University Hospital, Finnish Cancer Society, and Academy of Finland. The authors received grants, consulting/speaker/personal fees, research funding, compensation, and/or held patents outside this work.

Source: Vettenranta A et al. JAMA Oncol. 2021 Nov 24. doi: 10.1001/jamaoncol.2021.5672.

Key clinical point: Prostate-specific antigen (PSA)-based prostate cancer screening was associated with less overdiagnosis of low-risk cancer in statin users, with similar risk for advanced disease and mortality compared with nonusers.

Major finding: PSA screening was associated with increased prostate cancer incidence in statin nonusers (rate ratio [RR], 1.31; 95% CI, 1.24-1.38), but not in statin users (RR, 1.02; 95% CI, 0.95-1.10; P for interaction < .001). The screening was not associated with decreased mortality in statin users and nonusers.

Study details: A post hoc analysis of the Finnish Prostate Cancer Screening Trial in which 78,606 men were randomly assigned to either the screening or the control group.

Disclosures: This study was supported by Tampere University Hospital, Finnish Cancer Society, and Academy of Finland. The authors received grants, consulting/speaker/personal fees, research funding, compensation, and/or held patents outside this work.

Source: Vettenranta A et al. JAMA Oncol. 2021 Nov 24. doi: 10.1001/jamaoncol.2021.5672.

Key clinical point: In patients with prostate cancer undergoing active surveillance (AS), Gleason grade group (GG) 2 compared with GG1 at diagnosis was associated with a higher definitive treatment rate.

Major finding: There was no significant difference in the 5-year reclassification rates in patients with GG2 vs GG1 disease (30% vs 37%; P = .11). A higher proportion of patients with GG2 disease received treatment at 5 years (58% vs 34%; P < .001).

Study details: A prospective multicenter Canary PASS cohort study of 1,728 patients undergoing AS.

Disclosures: This work was supported by Canary Foundation and Institute for Prostate Cancer Research. The authors reported no conflict of interests.

Source: Malaret AJW et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002354.

Key clinical point: In patients with prostate cancer undergoing active surveillance (AS), Gleason grade group (GG) 2 compared with GG1 at diagnosis was associated with a higher definitive treatment rate.

Major finding: There was no significant difference in the 5-year reclassification rates in patients with GG2 vs GG1 disease (30% vs 37%; P = .11). A higher proportion of patients with GG2 disease received treatment at 5 years (58% vs 34%; P < .001).

Study details: A prospective multicenter Canary PASS cohort study of 1,728 patients undergoing AS.

Disclosures: This work was supported by Canary Foundation and Institute for Prostate Cancer Research. The authors reported no conflict of interests.

Source: Malaret AJW et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002354.

Key clinical point: In patients with prostate cancer undergoing active surveillance (AS), Gleason grade group (GG) 2 compared with GG1 at diagnosis was associated with a higher definitive treatment rate.

Major finding: There was no significant difference in the 5-year reclassification rates in patients with GG2 vs GG1 disease (30% vs 37%; P = .11). A higher proportion of patients with GG2 disease received treatment at 5 years (58% vs 34%; P < .001).

Study details: A prospective multicenter Canary PASS cohort study of 1,728 patients undergoing AS.

Disclosures: This work was supported by Canary Foundation and Institute for Prostate Cancer Research. The authors reported no conflict of interests.

Source: Malaret AJW et al. J Urol. 2021 Dec 2. doi: 10.1097/JU.0000000000002354.

Key clinical point: A significant patient- and surgeon-level variation in sexual function recovery is seen over 2 years after radical prostatectomy.

Major finding: At 24-month follow-up, 24% of patients recovered sexual function. Across 12 surgeons, patients achieving sexual function recovery ranged from 3% to 44%. At the surgeon level, the Pearson correlation coefficient between case volume and mean Expanded Prostate Cancer Index Composite-26 sexual domain score was 0.08 (95% CI, −0.52 to 0.62). The Spearman correlation coefficient between case volume and the proportion of patients achieving sexual function recovery was −0.16 (95% CI, −0.67 to 0.46).

Study details: A prospective cohort of 1,426 patients with prostate cancer who underwent radical prostatectomy between May 2014 and August 2019.

Disclosures: This work was supported by Blue Cross Blue Shield of Michigan and National Institutes of Health. The authors received financial/nonfinancial support and/or served as journal editors without compensation outside this work.

Source: Agochukwu-Mmonu N et al. JAMA Surg. 2021 Dec 1. doi: 10.1001/jamasurg.2021.6215.

Key clinical point: A significant patient- and surgeon-level variation in sexual function recovery is seen over 2 years after radical prostatectomy.

Major finding: At 24-month follow-up, 24% of patients recovered sexual function. Across 12 surgeons, patients achieving sexual function recovery ranged from 3% to 44%. At the surgeon level, the Pearson correlation coefficient between case volume and mean Expanded Prostate Cancer Index Composite-26 sexual domain score was 0.08 (95% CI, −0.52 to 0.62). The Spearman correlation coefficient between case volume and the proportion of patients achieving sexual function recovery was −0.16 (95% CI, −0.67 to 0.46).

Study details: A prospective cohort of 1,426 patients with prostate cancer who underwent radical prostatectomy between May 2014 and August 2019.

Disclosures: This work was supported by Blue Cross Blue Shield of Michigan and National Institutes of Health. The authors received financial/nonfinancial support and/or served as journal editors without compensation outside this work.

Source: Agochukwu-Mmonu N et al. JAMA Surg. 2021 Dec 1. doi: 10.1001/jamasurg.2021.6215.

Key clinical point: A significant patient- and surgeon-level variation in sexual function recovery is seen over 2 years after radical prostatectomy.

Major finding: At 24-month follow-up, 24% of patients recovered sexual function. Across 12 surgeons, patients achieving sexual function recovery ranged from 3% to 44%. At the surgeon level, the Pearson correlation coefficient between case volume and mean Expanded Prostate Cancer Index Composite-26 sexual domain score was 0.08 (95% CI, −0.52 to 0.62). The Spearman correlation coefficient between case volume and the proportion of patients achieving sexual function recovery was −0.16 (95% CI, −0.67 to 0.46).

Study details: A prospective cohort of 1,426 patients with prostate cancer who underwent radical prostatectomy between May 2014 and August 2019.

Disclosures: This work was supported by Blue Cross Blue Shield of Michigan and National Institutes of Health. The authors received financial/nonfinancial support and/or served as journal editors without compensation outside this work.

Source: Agochukwu-Mmonu N et al. JAMA Surg. 2021 Dec 1. doi: 10.1001/jamasurg.2021.6215.

Key clinical point: Treatment-related regret is common in patients with clinically localized prostate cancer. Patients undergoing surgery reported a significantly higher regret vs those undergoing radiotherapy or active surveillance.

Major finding: Overall treatment-related regret at 5 years was 13%. Treatment-related regret with surgery, radiotherapy, and active surveillance was 16%, 11%, and 7%, respectively. Patients who underwent surgery had a higher likelihood of regret than those who underwent active surveillance (adjusted odds ratio [aOR], 2.40; P < .001) or radiotherapy (aOR, 1.57; P = .01).

Study details: An observational study of 2,072 patients with clinically localized prostate cancer between 2011 and 2012.

Disclosures: This work was supported by Patient-Centered Outcomes Research Institute, Agency for Healthcare Research and Quality, and National Cancer Institute. The authors reported receiving personal fees and grants outside this work.

Source: Wallis CJD et al. JAMA Oncol. 2021 Nov 18. doi: 10.1001/jamaoncol.2021.5160.

Key clinical point: Treatment-related regret is common in patients with clinically localized prostate cancer. Patients undergoing surgery reported a significantly higher regret vs those undergoing radiotherapy or active surveillance.

Major finding: Overall treatment-related regret at 5 years was 13%. Treatment-related regret with surgery, radiotherapy, and active surveillance was 16%, 11%, and 7%, respectively. Patients who underwent surgery had a higher likelihood of regret than those who underwent active surveillance (adjusted odds ratio [aOR], 2.40; P < .001) or radiotherapy (aOR, 1.57; P = .01).

Study details: An observational study of 2,072 patients with clinically localized prostate cancer between 2011 and 2012.

Disclosures: This work was supported by Patient-Centered Outcomes Research Institute, Agency for Healthcare Research and Quality, and National Cancer Institute. The authors reported receiving personal fees and grants outside this work.

Source: Wallis CJD et al. JAMA Oncol. 2021 Nov 18. doi: 10.1001/jamaoncol.2021.5160.

Key clinical point: Treatment-related regret is common in patients with clinically localized prostate cancer. Patients undergoing surgery reported a significantly higher regret vs those undergoing radiotherapy or active surveillance.

Major finding: Overall treatment-related regret at 5 years was 13%. Treatment-related regret with surgery, radiotherapy, and active surveillance was 16%, 11%, and 7%, respectively. Patients who underwent surgery had a higher likelihood of regret than those who underwent active surveillance (adjusted odds ratio [aOR], 2.40; P < .001) or radiotherapy (aOR, 1.57; P = .01).

Study details: An observational study of 2,072 patients with clinically localized prostate cancer between 2011 and 2012.

Disclosures: This work was supported by Patient-Centered Outcomes Research Institute, Agency for Healthcare Research and Quality, and National Cancer Institute. The authors reported receiving personal fees and grants outside this work.

Source: Wallis CJD et al. JAMA Oncol. 2021 Nov 18. doi: 10.1001/jamaoncol.2021.5160.

Key clinical point: Nivolumab plus docetaxel shows good response in patients with chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC).

Major finding: The confirmed overall response rate was 40%. The median time to objective response was 2 months, and the median response duration was 7 months. The confirmed prostate-specific antigen (PSA) 50-response rate (50% or higher decline in PSA) was 46.9%.

Study details: A phase 2, nonrandomized CheckMate 9KD trial of 84 patients with chemotherapy-naive mCRPC who received androgen deprivation therapy and ≤2 prior novel hormonal therapies and were treated with nivolumab and docetaxel with prednisone followed by nivolumab maintenance for ≤2 years.

Disclosures: This work was supported by Bristol Myers Squibb (BMS). The authors reported receiving consulting/advisory/speaker fees, travel accommodations, expenses, honoraria, and research funding from various sources. Some authors were employed by/owned stocks in BMS.

Source: Fizazi K et al. Eur J Cancer. 2021 Nov 18. doi: 10.1016/j.ejca.2021.09.043.

Key clinical point: Nivolumab plus docetaxel shows good response in patients with chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC).

Major finding: The confirmed overall response rate was 40%. The median time to objective response was 2 months, and the median response duration was 7 months. The confirmed prostate-specific antigen (PSA) 50-response rate (50% or higher decline in PSA) was 46.9%.

Study details: A phase 2, nonrandomized CheckMate 9KD trial of 84 patients with chemotherapy-naive mCRPC who received androgen deprivation therapy and ≤2 prior novel hormonal therapies and were treated with nivolumab and docetaxel with prednisone followed by nivolumab maintenance for ≤2 years.

Disclosures: This work was supported by Bristol Myers Squibb (BMS). The authors reported receiving consulting/advisory/speaker fees, travel accommodations, expenses, honoraria, and research funding from various sources. Some authors were employed by/owned stocks in BMS.

Source: Fizazi K et al. Eur J Cancer. 2021 Nov 18. doi: 10.1016/j.ejca.2021.09.043.

Key clinical point: Nivolumab plus docetaxel shows good response in patients with chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC).

Major finding: The confirmed overall response rate was 40%. The median time to objective response was 2 months, and the median response duration was 7 months. The confirmed prostate-specific antigen (PSA) 50-response rate (50% or higher decline in PSA) was 46.9%.

Study details: A phase 2, nonrandomized CheckMate 9KD trial of 84 patients with chemotherapy-naive mCRPC who received androgen deprivation therapy and ≤2 prior novel hormonal therapies and were treated with nivolumab and docetaxel with prednisone followed by nivolumab maintenance for ≤2 years.

Disclosures: This work was supported by Bristol Myers Squibb (BMS). The authors reported receiving consulting/advisory/speaker fees, travel accommodations, expenses, honoraria, and research funding from various sources. Some authors were employed by/owned stocks in BMS.

Source: Fizazi K et al. Eur J Cancer. 2021 Nov 18. doi: 10.1016/j.ejca.2021.09.043.

Use of vascular lasers in the Medicare population is increasing, primarily among dermatologists. In addition, as a proportion of Medicare charges submitted that were reimbursed, the highest reimbursements were for dermatologists and those in the Western geographic region.

Those are among the key findings from an analysis that aimed to characterize trends in use and reimbursement patterns of vascular lasers in the Medicare-insured population.

“There are several modalities for vascular laser treatment, including the pulse dye laser, the frequency doubled KTP laser, and others,” presenting author Partik Singh, MD, MBA, said during a virtual abstract session at the annual meeting of the American Society for Dermatologic Surgery. “Laser treatment of vascular lesions may sometimes be covered by insurance, depending on the indication, but little is known about how and which clinicians are taking advantage of this covered treatment.”

Dr. Singh, a 2nd-year dermatology resident at the University of Rochester Medical Center, and coauthor Mara Weinstein Velez, MD, extracted data from the 2012-2018 Medicare Public Use File, which includes 100% fee-for-service, non–Medicare Advantage claims based on CPT codes, yet no information on patient data, clinical context, or indications. Outcomes of interest were total vascular laser claims per year, annual vascular laser claims per clinician, annual clinicians using vascular lasers, accepted reimbursements defined by the allowed charge or the submitted charge to Medicare, and clinical specialties and geographic location.

The researchers found that more than half of clinicians who used vascular lasers during the study period were dermatologists (55%), followed by general surgeons (6%), family practice/internal medicine physicians (5% each) and various others. Use of vascular lasers among all clinicians increased 10.5% annually during the study period, from 3,786 to 6,883, and was most pronounced among dermatologists, whose use increased 18.4% annually, from 1,878 to 5,182. “Nondermatologists did not have a big change in their overall utilization rate, but they did have a steady utilization of vascular lasers, roughly at almost 2,000 claims per year,” Dr. Singh said.

The researchers also observed that the use of vascular lasers on a per-clinician basis increased 7.4% annually among all clinicians during the study period, from 77.3 to 118.7. This was mostly driven by dermatologists, whose per-clinician use increased 10.4% annually, from 81.7 to 148.7. Use by nondermatologists remained about stable, with just a 0.1% increase annually, from 73.4 to 74. In addition, the number of clinicians who billed for vascular laser procedures increased 2.9% annually between 2012 and 2018, from 49 to 58. This growth was driven mostly by dermatologists, who increased their billing for vascular laser procedures by 7.2% annually, from 23 to 35 clinicians.

In other findings, dermatologists were reimbursed at 68.3% of submitted charges, compared with 59.3% of charges submitted by other clinicians (P = .0001), and reimbursement rates were greatest in the Western geographic region of the United States vs. the Northeast, Midwest, and Southern regions (73.1% vs. 50.2%, 65.4%, and 55.3%, respectively; P < .0001).

“Use of vascular lasers is increasing primarily among dermatologists, though there is steady use of these procedures by nondermatologists,” Dr. Singh concluded. “Medicare charges were more often fully reimbursed when billed by dermatologists and those in the Western U.S., perhaps suggesting a better familiarity with appropriate indications and better administrative resources for coverage of vascular laser procedures.”

After the meeting, Dr. Singh acknowledged certain limitations of the analysis, including the fact that it “was limited only to Medicare Part B fee-for-service claims, not including Medicare Advantage,” he told this news organization. “Our conclusions do not necessarily hold true for Medicaid or commercial insurers, for instance. Moreover, this dataset doesn’t provide patient-specific information, such as the indication for the procedure. Further studies are needed to characterize utilization of various lasers in not only Medicare beneficiaries, but also those with Medicaid, private insurance, and patients paying out-of-pocket. Additionally, study is also needed to explain why these differences in reimbursement hold true.”

The researchers reported having no relevant financial disclosures.

[email protected]

Use of vascular lasers in the Medicare population is increasing, primarily among dermatologists. In addition, as a proportion of Medicare charges submitted that were reimbursed, the highest reimbursements were for dermatologists and those in the Western geographic region.

Those are among the key findings from an analysis that aimed to characterize trends in use and reimbursement patterns of vascular lasers in the Medicare-insured population.

“There are several modalities for vascular laser treatment, including the pulse dye laser, the frequency doubled KTP laser, and others,” presenting author Partik Singh, MD, MBA, said during a virtual abstract session at the annual meeting of the American Society for Dermatologic Surgery. “Laser treatment of vascular lesions may sometimes be covered by insurance, depending on the indication, but little is known about how and which clinicians are taking advantage of this covered treatment.”

Dr. Singh, a 2nd-year dermatology resident at the University of Rochester Medical Center, and coauthor Mara Weinstein Velez, MD, extracted data from the 2012-2018 Medicare Public Use File, which includes 100% fee-for-service, non–Medicare Advantage claims based on CPT codes, yet no information on patient data, clinical context, or indications. Outcomes of interest were total vascular laser claims per year, annual vascular laser claims per clinician, annual clinicians using vascular lasers, accepted reimbursements defined by the allowed charge or the submitted charge to Medicare, and clinical specialties and geographic location.

The researchers found that more than half of clinicians who used vascular lasers during the study period were dermatologists (55%), followed by general surgeons (6%), family practice/internal medicine physicians (5% each) and various others. Use of vascular lasers among all clinicians increased 10.5% annually during the study period, from 3,786 to 6,883, and was most pronounced among dermatologists, whose use increased 18.4% annually, from 1,878 to 5,182. “Nondermatologists did not have a big change in their overall utilization rate, but they did have a steady utilization of vascular lasers, roughly at almost 2,000 claims per year,” Dr. Singh said.

The researchers also observed that the use of vascular lasers on a per-clinician basis increased 7.4% annually among all clinicians during the study period, from 77.3 to 118.7. This was mostly driven by dermatologists, whose per-clinician use increased 10.4% annually, from 81.7 to 148.7. Use by nondermatologists remained about stable, with just a 0.1% increase annually, from 73.4 to 74. In addition, the number of clinicians who billed for vascular laser procedures increased 2.9% annually between 2012 and 2018, from 49 to 58. This growth was driven mostly by dermatologists, who increased their billing for vascular laser procedures by 7.2% annually, from 23 to 35 clinicians.

In other findings, dermatologists were reimbursed at 68.3% of submitted charges, compared with 59.3% of charges submitted by other clinicians (P = .0001), and reimbursement rates were greatest in the Western geographic region of the United States vs. the Northeast, Midwest, and Southern regions (73.1% vs. 50.2%, 65.4%, and 55.3%, respectively; P < .0001).

“Use of vascular lasers is increasing primarily among dermatologists, though there is steady use of these procedures by nondermatologists,” Dr. Singh concluded. “Medicare charges were more often fully reimbursed when billed by dermatologists and those in the Western U.S., perhaps suggesting a better familiarity with appropriate indications and better administrative resources for coverage of vascular laser procedures.”

After the meeting, Dr. Singh acknowledged certain limitations of the analysis, including the fact that it “was limited only to Medicare Part B fee-for-service claims, not including Medicare Advantage,” he told this news organization. “Our conclusions do not necessarily hold true for Medicaid or commercial insurers, for instance. Moreover, this dataset doesn’t provide patient-specific information, such as the indication for the procedure. Further studies are needed to characterize utilization of various lasers in not only Medicare beneficiaries, but also those with Medicaid, private insurance, and patients paying out-of-pocket. Additionally, study is also needed to explain why these differences in reimbursement hold true.”

The researchers reported having no relevant financial disclosures.

[email protected]

Use of vascular lasers in the Medicare population is increasing, primarily among dermatologists. In addition, as a proportion of Medicare charges submitted that were reimbursed, the highest reimbursements were for dermatologists and those in the Western geographic region.

Those are among the key findings from an analysis that aimed to characterize trends in use and reimbursement patterns of vascular lasers in the Medicare-insured population.

“There are several modalities for vascular laser treatment, including the pulse dye laser, the frequency doubled KTP laser, and others,” presenting author Partik Singh, MD, MBA, said during a virtual abstract session at the annual meeting of the American Society for Dermatologic Surgery. “Laser treatment of vascular lesions may sometimes be covered by insurance, depending on the indication, but little is known about how and which clinicians are taking advantage of this covered treatment.”

Dr. Singh, a 2nd-year dermatology resident at the University of Rochester Medical Center, and coauthor Mara Weinstein Velez, MD, extracted data from the 2012-2018 Medicare Public Use File, which includes 100% fee-for-service, non–Medicare Advantage claims based on CPT codes, yet no information on patient data, clinical context, or indications. Outcomes of interest were total vascular laser claims per year, annual vascular laser claims per clinician, annual clinicians using vascular lasers, accepted reimbursements defined by the allowed charge or the submitted charge to Medicare, and clinical specialties and geographic location.

The researchers found that more than half of clinicians who used vascular lasers during the study period were dermatologists (55%), followed by general surgeons (6%), family practice/internal medicine physicians (5% each) and various others. Use of vascular lasers among all clinicians increased 10.5% annually during the study period, from 3,786 to 6,883, and was most pronounced among dermatologists, whose use increased 18.4% annually, from 1,878 to 5,182. “Nondermatologists did not have a big change in their overall utilization rate, but they did have a steady utilization of vascular lasers, roughly at almost 2,000 claims per year,” Dr. Singh said.

The researchers also observed that the use of vascular lasers on a per-clinician basis increased 7.4% annually among all clinicians during the study period, from 77.3 to 118.7. This was mostly driven by dermatologists, whose per-clinician use increased 10.4% annually, from 81.7 to 148.7. Use by nondermatologists remained about stable, with just a 0.1% increase annually, from 73.4 to 74. In addition, the number of clinicians who billed for vascular laser procedures increased 2.9% annually between 2012 and 2018, from 49 to 58. This growth was driven mostly by dermatologists, who increased their billing for vascular laser procedures by 7.2% annually, from 23 to 35 clinicians.

In other findings, dermatologists were reimbursed at 68.3% of submitted charges, compared with 59.3% of charges submitted by other clinicians (P = .0001), and reimbursement rates were greatest in the Western geographic region of the United States vs. the Northeast, Midwest, and Southern regions (73.1% vs. 50.2%, 65.4%, and 55.3%, respectively; P < .0001).

“Use of vascular lasers is increasing primarily among dermatologists, though there is steady use of these procedures by nondermatologists,” Dr. Singh concluded. “Medicare charges were more often fully reimbursed when billed by dermatologists and those in the Western U.S., perhaps suggesting a better familiarity with appropriate indications and better administrative resources for coverage of vascular laser procedures.”

After the meeting, Dr. Singh acknowledged certain limitations of the analysis, including the fact that it “was limited only to Medicare Part B fee-for-service claims, not including Medicare Advantage,” he told this news organization. “Our conclusions do not necessarily hold true for Medicaid or commercial insurers, for instance. Moreover, this dataset doesn’t provide patient-specific information, such as the indication for the procedure. Further studies are needed to characterize utilization of various lasers in not only Medicare beneficiaries, but also those with Medicaid, private insurance, and patients paying out-of-pocket. Additionally, study is also needed to explain why these differences in reimbursement hold true.”

The researchers reported having no relevant financial disclosures.

[email protected]