title: Primary care follow-up of radical prostatectomy patients: A regional New Zealand experience.
abstract: BACKGROUND
  Contemporary recommendations regarding the duration of follow-up after radical prostatectomy (RP) are highly heterogeneous. Protocol-based follow-up schemes have been implemented to facilitate the expeditious identification of patients with recurrence. The aim of this study is to assess the reliability and comfort of general practitioners (GPs) in follow-up of RP.
  
  
  METHODS
  Following institutional ethical approval, we performed a retrospective review in patients undergoing follow-up after RP between January 2004 and December 2010. Patient factors, disease variables, and follow-up prostate specific antigen (PSA) compliance was collected. "Noncompliant" follow-up care was defined as: patients that had not received a PSA for a 14 month period within 5 years of prostatectomy. Patient and disease-based risk factors for noncompliant follow-up were assessed. GPs were also surveyed in their follow-up practice of RP patients, to assess their familiarity in caring for these patients.
  
  
  RESULTS
  In total, 65 cases were identified that met the inclusion criteria. At 60 months of follow-up, 66% (43/65) of patients had a compliant follow-up regime. For patients with noncompliant follow-up at 60 months, median time of compliance did not differ significantly when assessing preoperative PSA, Gleason sum, extraprostatic extension, or surgical margin status. Of the GPs surveyed, 68% of GPs felt comfortable in follow-up of RP patients. Some 62% of GPs would expect the PSA to be < 0.1 and 25% of GPs would measure the PSA annually.
  
  
  CONCLUSIONS
  Our study identified that follow-up by GPs after RP is insufficient. Accordingly, there is a requirement for formal educational programs if primary care is to take a greater role in follow-up of these patients.
authors.affiliation: Department of Surgery, Nelson Marlborough District Health Board, Nelson, New Zealand; Department of Surgery, Capital and Coast District Health Board, Wellington, New Zealand.
authors.forename: Omid
authors.initials: O
authors.lastname: Yassaie
authors.affiliation: Department of Surgery, Nelson Marlborough District Health Board, Nelson, New Zealand.
authors.forename: Ben
authors.initials: B
authors.lastname: McLaughlin
authors.affiliation: Department of Surgery, Austin Health, University of Melbourne, Australia.
authors.forename: Marlon
authors.initials: M
authors.lastname: Perera
authors.affiliation: Department of Surgery, Austin Health, University of Melbourne, Australia.
authors.forename: Todd
authors.initials: T
authors.lastname: Manning
authors.affiliation: Department of Surgery, Austin Health, University of Melbourne, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Lawrentschuk
authors.affiliation: Department of Surgery, Nelson Marlborough District Health Board, Nelson, New Zealand.
authors.forename: Andrew
authors.initials: A
authors.lastname: Malcolm
keywords: Follow-up; General practitioner; Primary care; Prostate cancer; Prostate specific antigen; Radical prostatectomy