Locally advanced prostate cancer: a population‐based study of treatment patterns

• DOI: 10.1111/j.1464-410x.2011.10760.x
• Publication Date: 2011-11-16T11:37:09Z
• Authors: William T. Lowrance; Elena B. Elkin; David S. Yee; Andrew Feifer; Behfar Ehdaie; Lindsay M. Jacks; Coral L. Atoria; Michael J. Zelefsky; Howard I. Scher; Peter T. Scardino; James A. Eastham
• Keywords: Aged, 80 and over; Male; Prostatectomy; Radiotherapy; Prostatic Neoplasms; Androgen Antagonists; Combined Modality Therapy; United States; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Practice Patterns, Physicians'; Aged; SEER Program

Study Type – Therapy (practice patterns) Level of Evidence 2b What's known on the subject? and What does study add? The treatment locally advanced prostate cancer varies widely even though there is level one evidence supporting use multimodality therapy as compared with monotherapy. This defines patterns within United States identifies predicators who receives rather than OBJECTIVE To identify predictors receiving in patients (LAPC). PATIENTS AND METHODS cohort comprised ≥66 years clinical stage T3 or T4 non‐metastatic diagnosed between 1998 2005 identified from Surveillance, Epidemiology End Results (SEER) registry records linked Medicare claims. Treatments were classified radical prostatectomy (RP), radiation (RT) androgen deprivation (ADT) received 6 24 months diagnosis. We assessed trends over time used multivariable logistic regression to treatment. RESULTS Within first diagnosis, 1060 3095 (34%) treated a combination RT ADT, 1486 (48%) monotherapy (RT alone, ADT alone RP alone), 461 (15%) no active proportion increased, exceeding 10% 2005. Use combined fluctuated throughout period. In all 6% Multimodality was less common older, African American, unmarried, lived south, had co‐morbidities disease. CONCLUSIONS Treatment LAPC widely, shifted during slightly increased since 2003 encouraging, but further work needed increase appropriate define role RP.