PURPOSE: The Surveillance, Epidemiology, and End Results (SEER) registry recently released Gleason score at the time of biopsy/TURP, which, for the first time, permits accurate assessment of the presentation and treatment of prostate cancer according to clinical factors at diagnosis.
MATERIALS AND METHODS: The SEER database was used to identify men diagnosed with localized prostate cancer in 2010 who were assigned National Comprehensive Cancer Network (NCCN) risk based on clinical factors. We identified sociodemographic factors associated with having high-risk disease and analyzed the impact of these factors, along with NCCN risk, on local treatment.
RESULTS: 42,403 men were identified. 38% had low-risk, 40% had intermediate-risk, and 22% had high-risk disease. In multivariable analysis, patients who were older, non-White, non-married, or living in counties with higher poverty rates were more likely to be diagnosed with high-risk disease (all p < 0.05). Of the 38,634 men for whom prostate cancer was the first malignancy, 23% had no local treatment, 40% had prostatectomy, 36% had radiation treatment, and 1% had local tumor destruction (predominantly cryotherapy). In multivariable analysis, patients who were older, black, non-married, living in counties with higher poverty rates, or with low-risk disease were less likely to receive local treatment (all p < 0.05).
CONCLUSIONS: Our analysis provides information regarding the current clinical presentation and treatment of localized prostate cancer in the US. We found that non-white, older men, living in counties with higher poverty were more likely to be diagnosed with high-risk disease and less likely to receive local treatment.
Written by:
Mahmood U, Levy LB, Nguyen PL, Lee AK, Kuban DA, Hoffman KE. Are you the author?
Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA; Department of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Reference: J Urol. 2014 Jun 12. pii: S0022-5347(14)03767-7.
doi: 10.1016/j.juro.2014.06.017
PubMed Abstract
PMID: 24931803
UroToday.com Prostate Cancer Section
