Skip to main content

Advertisement

SpringerLink
Log in

A population-based analysis of contemporary patterns of care in younger men (<60 years old) with localized prostate cancer

  • Urology - Original article
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

To analyze patterns of care in younger patients (<60 years old) with localized prostate cancer and to identify factors associated with selection of therapy using a large, population-based database.

Methods

The Surveillance, Epidemiology, and End Results database was queried to identify men <60 years old diagnosed with localized prostate cancer between 2010 and 2011. Patients were determined to have undergone no active treatment, local therapy, radiation therapy (RT), or radical prostatectomy (RP). Univariate and multivariate logistic regression analyses were performed to identify factors associated with the use of definitive therapy.

Results

A total of 12,732 men were included in this analysis. For the entire cohort, 12.5 % received no definitive treatment, 61.6 % RP, 22.0 % RT, and 3.3 % RP with adjuvant RT. Among men with low-, intermediate-, and high-risk prostate cancer, 17.2, 7.1, and 15.9 %, respectively, received no definitive therapy. RP was the most common choice of definitive therapy, utilized in 74.6 % of patients. Adjuvant RT after RP was utilized in 16.2 % of cases with positive margin and/or pT3/pT4 disease. African-American race, single marital status, and Medicaid/no insurance were associated with a decreased likelihood of receiving definitive treatment.

Conclusions

A significant proportion of younger men diagnosed with localized prostate cancer, particularly with low- or high-risk disease, are not receiving definitive therapy. African-American men, uninsured men, and patients with Medicaid or no medical insurance are less likely to receive definitive treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. NCCN Clinical Practice Guidelines in Oncology (2015) Prostate cancer v1. http://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Accessed 1 May 2015

  2. Lu-Yao GL, Albertsen PC, Moore DF et al (2009) Outcomes of localized prostate cancer following conservative management. JAMA 302:1202–1209

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Lin DW, Porter M, Montgomery B (2009) Treatment and survival outcomes in young men diagnosed with prostate cancer: a population-based cohort. Cancer 115:2863–2871

    Article  PubMed Central  PubMed  Google Scholar 

  4. Salinas CA, Tsodikov A, Ishak-Howard M, Cooney KA (2014) Prostate cancer in young men: an important clinical entity. Nat Rev Urol 11:317–323

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Daskivich TJ, Kang-Hsien F, Koyama T et al (2015) Prediction of long-term other-cause mortality in men with early-stage prostate cancer: results from the Prostate Cancer Outcomes Study. Urology 85:92–100

    Article  PubMed  Google Scholar 

  6. Klotz L, Vesprini D, Sethukavalan P et al (2015) Long-term follow-up of a large active surveillance cohort of patients with prostate cancer. J Clin Oncol 33:272–277

    Article  PubMed  Google Scholar 

  7. Bill-Axelson A, Holmberg L, Garmo H et al (2014) Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med 370:932–942

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Wilt TJ, Brawer MK, Jones KM et al (2012) Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med 367:203–213

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Tyldesley S, McKenzie MR, So AI (2012) Radical prostatectomy versus observation for prostate cancer. N Engl J Med 367:1468

    CAS  PubMed  Google Scholar 

  10. Elliot SP, Johnson DP, Jarosek SL et al (2012) Bias due to missing SEER data in D’Amico risk stratification of prostate cancer. J Urol 187:2026–2031

    Article  Google Scholar 

  11. Mahmood U, Levy LB, Nguyen PL et al (2014) Current clinical presentation and treatment of localized prostate cancer in the United States. J Urol 192:1650–1656

    Article  PubMed  Google Scholar 

  12. Schymura MJ, Kahn AR, German RR et al (2010) Factors associated with initial treatment and survival for clinically localized prostate cancer: results from the CDC-NPCR Patterns of Care Study (PoC1). BMC Cancer 10:152

    Article  PubMed Central  PubMed  Google Scholar 

  13. Tosoian JT, Trock BJ, Landis P et al (2011) Active surveillance program for prostate cancer: an update of the Johns Hopkins experience. J Clin Oncol 29:2185–2190

    Article  PubMed  Google Scholar 

  14. van den Bergh RC, Vasarainen H, van der Poel HG et al (2010) Short-term outcomes of the prospective multicentre ‘Prostate Cancer Research International: Active Surveillance’ study. BJU Int 105:956–962

    Article  PubMed  Google Scholar 

  15. Mason MD, Parulekar WR, Sydes MR, et al. (2015) Final report of the Intergroup randomized study of combined androgen-deprivation therapy plus radiotherapy versus androgen-deprivation therapy alone in locally advanced prostate cancer. J Clin Oncol 33:2143–2150

    Article  PubMed Central  PubMed  Google Scholar 

  16. Widmark A, Klepp O, Solberg A et al (2009) Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial. Lancet 73:301–308

    Article  Google Scholar 

  17. Lane JA, Donovan JL, Davis M et al (2014) Active monitoring, radical prostatectomy, or radiotherapy for localised prostate cancer: study design and diagnostic and baseline results of the ProtecT randomised phase 3 trial. Lancet Oncol 15:1109–1118

    Article  PubMed  Google Scholar 

  18. Mahal BA, Aizer AA, Ziehr DR et al (2014) Trends in disparate treatment of African American men with localized prostate cancer across National Comprehensive Cancer Network risk groups. Urology 84:286–292

    Article  Google Scholar 

  19. Mahal BA, Ziehr DR, Aizer AA et al (2014) Getting back to equal: the influence of insurance status on racial disparities in the treatment of African American men with high-risk prostate cancer. Urol Oncol 32:1285–1291

    Article  PubMed  Google Scholar 

  20. Aizer AA, Chen MH, McCarthy EP et al (2013) Marital status and survival in patients with cancer. J Clin Oncol 31:3869–3876

    Article  PubMed  Google Scholar 

  21. Denberg TD, Beaty BL, Kim FJ, Steiner JF (2005) Marriage and ethnicity predict treatment in localized prostate carcinoma. Cancer 103:1819–1825

    Article  PubMed  Google Scholar 

  22. Valicenti RK, Thompson I Jr, Albertsen P et al (2013) Adjuvant and salvage radiation therapy after prostatectomy: American Society for Radiation Oncology/American Urological Association guidelines. Int J Radiat Oncol Biol Phys 86:822–828

    Article  PubMed  Google Scholar 

  23. Schreiber D, Rineer J, Yu JB et al (2010) Analysis of pathologic extent of disease for clinically localized prostate cancer after radical prostatectomy and subsequent use of adjuvant radiation in a national cohort. Cancer 116:5757–5766

    Article  PubMed  Google Scholar 

  24. Kalbasi A, Swisher-McClure S, Mitra N et al (2014) Low rates of adjuvant radiation in patients with nonmetastatic prostate cancer with high-risk pathologic features. Cancer 120:3089–3096

    Article  PubMed Central  PubMed  Google Scholar 

  25. PSA Values and SEER Data, 1973–2012. http://seer.cancer.gov/data/psa-values.html. Accessed 1 May 2015

Download references

Author information

Authors and Affiliations

  1. Department of Veterans Affairs, New York Harbor Healthcare System, Brooklyn, NY, USA

    Andrew T. Wong, Joseph J. Safdieh, Joseph Weiner, David Schwartz & David Schreiber

  2. Department of Radiation Oncology, SUNY Downstate Medical Center, 450 Clarkson Ave, Box 1211, Brooklyn, NY, 11203, USA

    Andrew T. Wong, Joseph J. Safdieh, Joseph Weiner, David Schwartz & David Schreiber

  3. UF Health Cancer Center - Orlando Health, Orlando, FL, USA

    Justin Rineer

Authors
  1. Andrew T. Wong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph J. Safdieh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Justin Rineer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joseph Weiner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Schwartz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Schreiber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew T. Wong.

Ethics declarations

Conflict of interest

Andrew Wong declares that he has no conflict of interest. Joseph Safdieh declares that he has no conflict of interest. Justin Rineer declares that he has no conflict of interest. Joseph Weiner declares that he has no conflict of interest. David Schwartz declares that he has no conflict of interest. David Schreiber declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wong, A.T., Safdieh, J.J., Rineer, J. et al. A population-based analysis of contemporary patterns of care in younger men (<60 years old) with localized prostate cancer. Int Urol Nephrol 47, 1629–1634 (2015). https://doi.org/10.1007/s11255-015-1096-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-015-1096-8

Keywords

Search

Navigation