Background

Active surveillance (AS)/watchful waiting (WW) strategy for localized prostate cancer (PCa) is increasingly and broadly endorsed as a preferred option for initial treatment of men with very low- and low-risk PCa, but outcomes can be difficult to analyze in traditional, population-based registries. The recently released Surveillance, Epidemiology, and End Results (SEER) Prostate with WW dataset provides an opportunity to understand national patterns and trends in AS/WW, but the data source itself has not been well described.

Objective

To provide a comprehensive description of this dataset and investigate possible biases due to missing data.

Design, setting, and participants

The SEER is a population-based epidemiologic registry in the USA. Newly diagnosed PCa patient data were collected from 18 SEER registries between 2010 and 2015, with inclusion of a new treatment variable for AS/WW. We identified 316 724 patients in the entire cohort and 257 060 men with clinically localized PCa (T1-2N0M0).

Intervention

Various primary treatments for PCa.

Outcome measurements and statistical analysis

The degree of missing data for each variable was measured. In order to investigate possible bias due to missing data for cancer characterization, we compared two versions of the data: one that excluded cases with missing data and one dataset generated applying multiple imputations.

Results and limitations

Only 46% of cases had complete data on basic cancer characteristics for risk stratification. The excluded dataset (N = 118 821) differed significantly from the multiple imputation dataset (N = 257 060) in the distribution of every reported variable (all p < 0.001). The dataset does not distinguish WW from AS, which is a limitation.

Conclusions

While the SEER Prostate with WW dataset offers a new method to describe treatment trends for men with PCa, including the use of AS/WW, the amount of missing data should not be ignored.

Patient summary

While the Surveillance, Epidemiology, and End Results Prostate with Watchful Waiting dataset offers a new method to describe treatment trends for men with prostate cancer, including the use of active surveillance, it has a significant amount of missing data, which can be a source of potential bias if not addressed properly.

中文翻译：

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带有等待数据库的新监视，流行病学和最终结果前列腺：机遇与局限。

背景

对于局灶性前列腺癌（PCa）的低危和低危男性，初始治疗的首选方法是主动监测（AS）/观察等待（WW）策略，这一点已得到越来越广泛的认可，但结果很难分析在传统的基于人口的注册表中。最近发布的带有WW数据集的监视，流行病学和最终结果（SEER）前列腺提供了了解AS / WW的国家模式和趋势的机会，但是数据源本身并未得到很好的描述。

目的

提供此数据集的全面描述并调查由于缺少数据而可能出现的偏差。

设计，设置和参与者

SEER是美国的一种基于人群的流行病学注册表。在2010年至2015年之间，从18个SEER注册中心收集了新诊断的PCa患者数据，其中包括AS / WW的新治疗变量。我们确定了整个队列中的316 724例患者和257 060例具有临床定位PCa（T1-2N0M0）的男性。

介入

PCa的各种主要治疗方法。

成果测量和统计分析

测量每个变量的缺失数据的程度。为了调查由于缺少用于癌症表征的数据而可能造成的偏倚，我们比较了两种数据版本：一种排除了缺少数据的病例，另一种使用多个估算生成的数据集。

结果与局限性

只有46％的病例具有用于风险分层的基本癌症特征的完整数据。 在每个报告变量的分布中，被排除的数据集（N  = 118 821）与多重归因数据集（N = 257 060）显着不同（所有p  <0.001）。数据集不能将WW与AS区别开来，这是一个限制。

结论

尽管带有WW数据的SEER前列腺数据集提供了一种描述PCa男性治疗趋势的新方法，包括AS / WW的使用，但不应忽略丢失的数据量。

病人总结

尽管“监视，流行病学和最终结果以等待观察的前列腺数据集”提供了一种描述前列腺癌男性治疗趋势的新方法，包括使用主动监测，但仍有大量的缺失数据，这可能是导致癌症的原因之一。如果处理不当，可能会产生潜在的偏见。