Journal article
Trends and predictors of aggressive therapy for clinical locally advanced prostate carcinoma
BJU international, Vol.98(2), pp.335-340
2006
DOI: 10.1111/j.1464-410X.2006.06260.x
PMID: 16879674
Abstract
Objective: To determine the patterns and predictors of aggressive local therapies for patients with clinically advanced (cT3) prostate carcinoma, as the USA National Cancer Institute considers external beam radiotherapy (EBRT) to be the most appropriate treatment for these patients, and currently there is less evidence supporting the use of radical prostatectomy (RP).
Patients and methods: We used the Surveillance, Epidemiology and End Results (SEER) cancer registries to identify patients diagnosed with cT3 disease between 1995 and 2001. Sociodemographic and clinical data included patient age, race/ethnicity, marital status, SEER registry, year of diagnosis, tumour stage and grade, and treatment. Multivariate logistic regression was used to identify significant predictors of receiving (i) RP vs EBRT, (ii) any aggressive local treatment (RP or EBRT) or no treatment.
Results: Between 1995 and 2001, the proportion of men receiving aggressive local therapy for cT3 disease increased by 11% (58.4% to 69.4%), with a 20% increase in EBRT (40.3% to 60.2%) but a decline by half in RP (18.1% to 9.3%). Younger age was the strongest predictor of receiving RP rather than EBRT, and younger age with being married being a predictor of receiving aggressive local therapy (adjusted relative risk for marriage 1.33, 95% confidence interval 1.18-1.87). Black men were significantly less likely than non-Hispanic white men to receive aggressive therapy, with a relative risk of 0.56 (0.45-0.69).
Conclusion: By 2001, 70% of patients with cT3 disease were receiving aggressive local therapy, with EBRT 6.5 times more common than RP. Clinical trials are needed to rigorously assess the effects of different local treatment strategies on clinical outcomes in men with cT3 prostate carcinoma.
Details
- Title: Subtitle
- Trends and predictors of aggressive therapy for clinical locally advanced prostate carcinoma
- Creators
- Thomas D DENBERG - University of Colorado at Denver and Health Sciences Center, Denver, CO, United StatesL. Michael GLODE - University of Colorado at Denver and Health Sciences Center, Denver, CO, United StatesJohn F STEINER - University of Colorado at Denver and Health Sciences Center, Denver, CO, United StatesE. David CRAWFORD - University of Colorado at Denver and Health Sciences Center, Denver, CO, United StatesRichard M HOFFMAN - University of New Mexico and New Mexico Veterans Affairs Health Care System, NM, United States
- Resource Type
- Journal article
- Publication Details
- BJU international, Vol.98(2), pp.335-340
- Publisher
- Blackwell
- DOI
- 10.1111/j.1464-410X.2006.06260.x
- PMID
- 16879674
- ISSN
- 1464-4096
- eISSN
- 1464-410X
- Language
- English
- Date published
- 2006
- Academic Unit
- Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094633102771
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