OBJECTIVES: With the widespread use of prostate-specific antigen testing, an increasing number of men are diagnosed with favorable-risk prostate cancer (PC). Recently, emphasis has been placed on active surveillance for selected men with favorable-risk PC to avoid unnecessary treatment for tumors that may be clinically insignificant. We performed a population-based analysis to assess patterns of initial treatment (IT) for a contemporary cohort of elderly men diagnosed with a favorable-risk PC in the United States. METHODS: We used the Surveillance, Epidemiology, and End Results database to identify men aged more than or equal to 70 years diagnosed with a favorable-risk PC from 2004 to 2008. Multivariable logistic regression analyses were performed to determine patient, tumor, and socioeconomic factors associated with IT. RESULTS: A total of 15,108 men more than or equal to 70 years with a favorable-risk PC were identified. Prostatectomy was performed in 2.6% of patients. Fifty-nine percent of patients were recommended to undergo radiation therapy (RT). Among patients 70 to 74 years, 66.45% were recommended to undergo RT. Fifty-nine percent, 36.6%, and 15.8% of patients between 75 and 79, 80 and 84, and more than or equal to 85 years were recommended to receive RT, respectively. Factors significantly associated with IT on multivariable logistic regression analysis included: younger age, white race, Gleason Score 6 (vs.≤5), married marital status, and no history of prior malignancy. We also identified significant geographic variations in patterns of IT. CONCLUSIONS: A large percentage of elderly men diagnosed with favorable-risk PC undergo IT, most commonly with RT. Future research should be performed to identify barriers to patient and physician acceptance of active surveillance.
OBJECTIVES: With the widespread use of prostate-specific antigen testing, an increasing number of men are diagnosed with favorable-risk prostate cancer (PC). Recently, emphasis has been placed on active surveillance for selected men with favorable-risk PC to avoid unnecessary treatment for tumors that may be clinically insignificant. We performed a population-based analysis to assess patterns of initial treatment (IT) for a contemporary cohort of elderly men diagnosed with a favorable-risk PC in the United States. METHODS: We used the Surveillance, Epidemiology, and End Results database to identify men aged more than or equal to 70 years diagnosed with a favorable-risk PC from 2004 to 2008. Multivariable logistic regression analyses were performed to determine patient, tumor, and socioeconomic factors associated with IT. RESULTS: A total of 15,108 men more than or equal to 70 years with a favorable-risk PC were identified. Prostatectomy was performed in 2.6% of patients. Fifty-nine percent of patients were recommended to undergo radiation therapy (RT). Among patients 70 to 74 years, 66.45% were recommended to undergo RT. Fifty-nine percent, 36.6%, and 15.8% of patients between 75 and 79, 80 and 84, and more than or equal to 85 years were recommended to receive RT, respectively. Factors significantly associated with IT on multivariable logistic regression analysis included: younger age, white race, Gleason Score 6 (vs.≤5), married marital status, and no history of prior malignancy. We also identified significant geographic variations in patterns of IT. CONCLUSIONS: A large percentage of elderly men diagnosed with favorable-risk PC undergo IT, most commonly with RT. Future research should be performed to identify barriers to patient and physician acceptance of active surveillance.
Authors: Patrick O Richard; Shabbir M H Alibhai; Tony Panzarella; Laurence Klotz; Maria Komisarenko; Neil E Fleshner; David Urbach; Antonio Finelli Journal: Can Urol Assoc J Date: 2016 Sep-Oct Impact factor: 1.862
Authors: Stacy Loeb; Marc A Bjurlin; Joseph Nicholson; Teuvo L Tammela; David F Penson; H Ballentine Carter; Peter Carroll; Ruth Etzioni Journal: Eur Urol Date: 2014-01-09 Impact factor: 20.096
Authors: Kathryn L Taylor; Richard M Hoffman; Kimberly M Davis; George Luta; Amethyst Leimpeter; Tania Lobo; Scott P Kelly; Jun Shan; David Aaronson; Catherine A Tomko; Amy J Starosta; Charlotte J Hagerman; Stephen K Van Den Eeden Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-06-02 Impact factor: 4.254