Usama Mahmood1, Lawrence B Levy2, Paul L Nguyen2, Andrew K Lee2, Deborah A Kuban2, Karen E Hoffman2. 1. Departments of Radiation Oncology, M.D. Anderson Cancer Center, Houston, Texas, and Brigham and Women's Hospital, Harvard Medical School (PLN), Boston, Massachusetts. Electronic address: umahmood@mdanderson.org. 2. Departments of Radiation Oncology, M.D. Anderson Cancer Center, Houston, Texas, and Brigham and Women's Hospital, Harvard Medical School (PLN), Boston, Massachusetts.
Abstract
PURPOSE: SEER recently released patient Gleason scores at biopsy/transurethral resection of the prostate. For the first time this permits accurate assessment of prostate cancer presentation and treatment according to clinical factors at diagnosis. MATERIALS AND METHODS: We used the SEER database to identify men diagnosed with localized prostate cancer in 2010 who were assigned NCCN(®) risk based on clinical factors. We identified sociodemographic factors associated with high risk disease and analyzed the impact of these factors along with NCCN risk on local treatment. RESULTS: Of the 42,403 men identified disease was high, intermediate and low risk in 38%, 40% and 22%, respectively. On multivariate analysis patients who were older, nonwhite, unmarried or living in a county with a higher poverty rate were more likely to be diagnosed with high risk disease (each p <0.05). Of the 38,634 men in whom prostate cancer was the first malignancy 23% underwent no local treatment, 40% were treated with prostatectomy, 36% received radiation therapy and 1% underwent local tumor destruction, predominantly cryotherapy. On multivariate analysis patients who were older, black, unmarried or living in a county with a higher poverty rate, or who had low risk disease were less likely to receive local treatment (each p <0.05). CONCLUSIONS: Our analysis provides information on the current clinical presentation and treatment of localized prostate cancer in the United States. Nonwhite and older men living in a county with a higher poverty rate were more likely to be diagnosed with high risk disease and less likely to receive local treatment.
PURPOSE: SEER recently released patient Gleason scores at biopsy/transurethral resection of the prostate. For the first time this permits accurate assessment of prostate cancer presentation and treatment according to clinical factors at diagnosis. MATERIALS AND METHODS: We used the SEER database to identify men diagnosed with localized prostate cancer in 2010 who were assigned NCCN(®) risk based on clinical factors. We identified sociodemographic factors associated with high risk disease and analyzed the impact of these factors along with NCCN risk on local treatment. RESULTS: Of the 42,403 men identified disease was high, intermediate and low risk in 38%, 40% and 22%, respectively. On multivariate analysis patients who were older, nonwhite, unmarried or living in a county with a higher poverty rate were more likely to be diagnosed with high risk disease (each p <0.05). Of the 38,634 men in whom prostate cancer was the first malignancy 23% underwent no local treatment, 40% were treated with prostatectomy, 36% received radiation therapy and 1% underwent local tumor destruction, predominantly cryotherapy. On multivariate analysis patients who were older, black, unmarried or living in a county with a higher poverty rate, or who had low risk disease were less likely to receive local treatment (each p <0.05). CONCLUSIONS: Our analysis provides information on the current clinical presentation and treatment of localized prostate cancer in the United States. Nonwhite and older men living in a county with a higher poverty rate were more likely to be diagnosed with high risk disease and less likely to receive local treatment.
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: Amar Bhindi; Bimal Bhindi; Girish S Kulkarni; Robert J Hamilton; Ants Toi; Theodorus H van der Kwast; Andrew Evans; Alexandre R Zlotta; Antonio Finelli; Neil E Fleshner Journal: Can Urol Assoc J Date: 2017 Jan-Feb Impact factor: 1.862
Authors: Andrew T Wong; Joseph J Safdieh; Justin Rineer; Joseph Weiner; David Schwartz; David Schreiber Journal: Int Urol Nephrol Date: 2015-09-02 Impact factor: 2.370
Authors: Joseph R Evans; Shuang G Zhao; S Laura Chang; Scott A Tomlins; Nicholas Erho; Andrea Sboner; Matthew J Schiewer; Daniel E Spratt; Vishal Kothari; Eric A Klein; Robert B Den; Adam P Dicker; R Jeffrey Karnes; Xiaochun Yu; Paul L Nguyen; Mark A Rubin; Johann de Bono; Karen E Knudsen; Elai Davicioni; Felix Y Feng Journal: JAMA Oncol Date: 2016-04 Impact factor: 31.777
Authors: Karen E Hoffman; K Ranh Voong; Lawrence B Levy; Pamela K Allen; Seungtaek Choi; Pamela J Schlembach; Andrew K Lee; Sean E McGuire; Quynh Nguyen; Thomas J Pugh; Steven J Frank; Rajat J Kudchadker; Weiliang Du; Deborah A Kuban Journal: J Clin Oncol Date: 2018-08-14 Impact factor: 50.717