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

Area of Science:

• Urology
• Oncology
• Health Services Research

Background:

• Treatment for locally advanced prostate cancer (LAPC) lacks standardization, despite evidence favoring multimodality therapy over monotherapy.
• Significant variations in treatment patterns exist within the United States.

Purpose of the Study:

• To identify current treatment patterns for LAPC.
• To determine predictors for receiving multimodality therapy versus monotherapy.

Main Methods:

• Analysis of Surveillance, Epidemiology and End Results (SEER) records linked with Medicare claims for patients aged ≥66 with non-metastatic prostate cancer (T3-T4).
• Classified treatments as radical prostatectomy (RP), radiation therapy (RT), and androgen deprivation therapy (ADT).
• Used multivariable logistic regression to identify predictors of multimodality treatment.

Main Results:

• Within 6 months, 34% received RT and ADT combination, 48% received monotherapy, and 15% received no active treatment.
• Radical prostatectomy (RP) use increased to over 10% by 2005.
• Multimodality therapy was less frequent in older, African American, unmarried patients, and those with comorbidities or stage T4 disease.

Conclusions:

• Treatment patterns for LAPC are diverse and have evolved.
• While a slight increase in multimodality therapy is noted, further efforts are required to enhance its use in appropriate patients and clarify the role of RP.