PURPOSE: We compare secondary cancer treatment use in patients who underwent definitive local treatment for prostate cancer. MATERIALS AND METHODS: The rate of second cancer treatment was determined in patients who underwent radical prostatectomy (1,254), radiotherapy (499) or cryosurgery (141) using data from the CaPSURE database, a longitudinal disease registry of patients with prostate cancer. Second treatments started within 3 months after initial treatment were defined as adjuvant and those started more than 3 months were defined as nonadjuvant. Using a parametric regression model of survival analysis, second treatment rates were adjusted for differences in clinical and demographic characteristics, and duration of followup among groups. RESULTS: Of the patients 4% received a second adjuvant treatment and 17% received a second nonadjuvant treatment within 3 years of initial therapy. Adjusted rates of nonadjuvant second treatment were lowest after radical prostatectomy, and 34 and 88% higher after radiation and cryosurgery, respectively (p = 0.01). This finding was most evident in patients with pretreatment prostate specific antigen 10.0 ng./ml. or less, clinical stage T2N0M0 disease, or Gleason score 6 or less on diagnostic biopsy, and in those classified as low risk for recurrence based on a combination of these parameters (p = 0.004). CONCLUSIONS: Approximately 1 in 5 patients receive second cancer treatment within a mean of 3 years following initial local treatment for prostate cancer. Our data suggest that the likelihood of receiving second treatment was lowest in patients initially treated with radical prostatectomy.
PURPOSE: We compare secondary cancer treatment use in patients who underwent definitive local treatment for prostate cancer. MATERIALS AND METHODS: The rate of second cancer treatment was determined in patients who underwent radical prostatectomy (1,254), radiotherapy (499) or cryosurgery (141) using data from the CaPSURE database, a longitudinal disease registry of patients with prostate cancer. Second treatments started within 3 months after initial treatment were defined as adjuvant and those started more than 3 months were defined as nonadjuvant. Using a parametric regression model of survival analysis, second treatment rates were adjusted for differences in clinical and demographic characteristics, and duration of followup among groups. RESULTS: Of the patients 4% received a second adjuvant treatment and 17% received a second nonadjuvant treatment within 3 years of initial therapy. Adjusted rates of nonadjuvant second treatment were lowest after radical prostatectomy, and 34 and 88% higher after radiation and cryosurgery, respectively (p = 0.01). This finding was most evident in patients with pretreatment prostate specific antigen 10.0 ng./ml. or less, clinical stage T2N0M0 disease, or Gleason score 6 or less on diagnostic biopsy, and in those classified as low risk for recurrence based on a combination of these parameters (p = 0.004). CONCLUSIONS: Approximately 1 in 5 patients receive second cancer treatment within a mean of 3 years following initial local treatment for prostate cancer. Our data suggest that the likelihood of receiving second treatment was lowest in patients initially treated with radical prostatectomy.
Authors: T N Showalter; K A Foley; E Jutkowitz; C D Lallas; E J Trabulsi; L G Gomella; A P Dicker; L T Pizzi Journal: Ann Oncol Date: 2011-06-09 Impact factor: 32.976