Comparative Effectiveness of Treatment Alternatives for Localized Prostate Cancer



A patient newly diagnosed with prostate cancer in 2011 faces a potentially bewildering menu of treatment options. Alternatives endorsed by the American Urological Association (AUA)’s 2007 practice guideline for localized prostate cancer [1], for example, include active surveillance, radical prostatectomy, interstitial radiation (brachytherapy), or external beam radiation therapy (EBRT). However, the detailed list of options becomes longer, including among surgical options open radical retropubic prostatectomy (ORRP), radical perineal prostatectomy (RPP), “straight” laparoscopic radical prostatectomy (LRP), and robot-assisted radical prostatectomy (RARP), within brachytherapy, permanent (low-dose rate) seed implantation or temporary (high-dose rate [HDR]) via catheters, and within EBRT, “conventional” 3-D conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), or proton beam therapy, possibly combined with brachytherapy and/or with androgen deprivation therapy (ADT). Other options not necessarily endorsed by the guideline but frequently used in practice include primary ADT (PADT) monotherapy and cryotherapy; those traveling outside the United States also have the option of high-intensity focused ultrasound (HIFU).


Prostate Cancer External Beam Radiation Therapy Androgen Deprivation Therapy Localize Prostate Cancer Watchful Waiting 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Thompson I, Thrasher JB, Aus G, et al. Guideline for the management of clinically localized prostate cancer: 2007 update. J Urol. 2007;177(6):2106–31.PubMedCrossRefGoogle Scholar
  2. 2.
    Sanda MG, Dunn RL, Michalski J, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med. 2008;358(12):1250–61.PubMedCrossRefGoogle Scholar
  3. 3.
    Pardo Y, Guedea F, Aguilo F, et al. Quality-of-life impact of primary treatments for localized prostate cancer in patients without hormonal treatment. J Clin Oncol. 2010;28(31):4687–96.PubMedCrossRefGoogle Scholar
  4. 4.
    Wilt TJ, MacDonald R, Rutks I, Shamliyan TA, Taylor BC, Kane RL. Systematic review: comparative effectiveness and harms of treatments for clinically localized prostate cancer. Ann Intern Med. 2008;148(6):435–48.PubMedGoogle Scholar
  5. 5.
    The Center for Evaluative Clinical Sciences at Dartmouth Medical School. The quality of medical care in the United States. Hanover: American Hospital Association; 1999.Google Scholar
  6. 6.
    Shahinian VB, Kuo YF, Freeman JL, Goodwin JS. Determinants of androgen deprivation therapy use for prostate cancer: role of the urologist. J Natl Cancer Inst. 2006;98(12):839–45.PubMedCrossRefGoogle Scholar
  7. 7.
    Cooperberg MR, Broering JM, Carroll PR. Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol. 2010;28:1117.PubMedCrossRefGoogle Scholar
  8. 8.
    Wennberg JE, Fisher ES, Skinner JS. Geography and the debate over Medicare reform. Health Aff (Millwood). 2002;Suppl Web Exclusives:W96–114.Google Scholar
  9. 9.
    Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care. Ann Intern Med. 2003;138(4):288–98.PubMedGoogle Scholar
  10. 10.
    Institute of Medicine Committee on Comparative Effectiveness Research Prioritization. Initial national priorities for comparative effectiveness research. Washington, D.C.: National Academy Press; 2009.Google Scholar
  11. 11.
    Iversen P, Madsen PO, Corle DK. Radical prostatectomy versus expectant treatment for early carcinoma of the prostate. Twenty-three year follow-up of a prospective randomized study. Scand J Urol Nephrol Suppl. 1995;172:65–72.PubMedGoogle Scholar
  12. 12.
    Bill-Axelson A, Holmberg L, Ruutu M, et al. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med. 2011;364(18):1708–17.PubMedCrossRefGoogle Scholar
  13. 13.
    Steineck G, Helgesen F, Adolfsson J, et al. Quality of life after radical prostatectomy or watchful waiting. N Engl J Med. 2002;347(11):790–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Widmark A, Klepp O, Solberg A, et al. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial. Lancet. 2009;373:301.PubMedCrossRefGoogle Scholar
  15. 15.
    Warde PR, Mason MD, Ding K, et al. Survival benefit with combined androgen deprivation and radiation therapy in locally advanced prostate cancer – results of a phase III trial. Lancet. 2011;378:2104–11.PubMedCrossRefGoogle Scholar
  16. 16.
    Paulson DF, Lin GH, Hinshaw W, Stephani S. Radical surgery versus radiotherapy for adenocarcinoma of the prostate. J Urol. 1982;128(3):502–4.PubMedGoogle Scholar
  17. 17.
    Wallace K, Fleshner N, Jewett M, Basiuk J, Crook J. Impact of a multi-disciplinary patient education session on accrual to a difficult clinical trial: the Toronto experience with the surgical prostatectomy versus interstitial radiation intervention trial. J Clin Oncol. 2006;24(25):4158–62.PubMedCrossRefGoogle Scholar
  18. 18.
    Wilt TJ, Brawer MK, Barry MJ, et al. The prostate cancer intervention versus observation trial:VA/NCI/AHRQ cooperative studies program #407 (PIVOT): design and baseline results of a randomized controlled trial comparing radical prostatectomy to watchful waiting for men with clinically localized prostate cancer. Contemp Clin Trials. 2009;30:81–7. Epub 2008 Aug 23.PubMedCrossRefGoogle Scholar
  19. 19.
    Donovan JL, Lane JA, Peters TJ, et al. Development of a complex intervention improved randomization and informed consent in a randomized controlled trial. J Clin Epidemiol. 2009;62(1):29–36.PubMedCrossRefGoogle Scholar
  20. 20.
    Cookson MS, Aus G, Burnett AL, et al. Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel report and recommendations for a standard in the reporting of surgical outcomes. J Urol. 2007;177(2):540–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Freedland SJ, Humphreys EB, Mangold LA, et al. Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA. 2005;294(4):433–9.PubMedCrossRefGoogle Scholar
  22. 22.
    ASTRO. Consensus statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys. 1997;37:1035–41.Google Scholar
  23. 23.
    Roach 3rd M, Hanks G, Thames Jr H, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO phoenix consensus conference. Int J Radiat Oncol Biol Phys. 2006;65(4):965–74.PubMedCrossRefGoogle Scholar
  24. 24.
    Gretzer MB, Trock BJ, Han M, Walsh PC. A critical analysis of the interpretation of biochemical failure in surgically treated patients using the American Society for Therapeutic Radiation and Oncology criteria. J Urol. 2002;168(4 Pt 1):1419–22.PubMedGoogle Scholar
  25. 25.
    Nielsen ME, Makarov DV, Humphreys E, Mangold L, Partin AW, Walsh PC. Is it possible to compare PSA recurrence-free survival after surgery and radiotherapy using revised ASTRO criterion–“nadir +2”? Urology. 2008;72(2):389–93.PubMedCrossRefGoogle Scholar
  26. 26.
    Shariat SF, Karakiewicz PI, Roehrborn CG, Kattan MW. An updated catalog of prostate cancer predictive tools. Cancer. 2008;113(11):3075–99.PubMedCrossRefGoogle Scholar
  27. 27.
    Kattan MW, Zelefsky MJ, Kupelian PA, et al. Pretreatment nomogram that predicts 5-year probability of metastasis following three-dimensional conformal radiation therapy for localized prostate cancer. J Clin Oncol. 2003;21(24):4568–71.PubMedCrossRefGoogle Scholar
  28. 28.
    D’Amico AV, Moul J, Carroll PR, Sun L, Lubeck D, Chen MH. Cancer-specific mortality after surgery or radiation for patients with clinically localized prostate cancer managed during the prostate-specific antigen era. J Clin Oncol. 2003;21(11):2163–72.PubMedCrossRefGoogle Scholar
  29. 29.
    Cooperberg MR, Broering JM, Carroll PR. Risk assessment for prostate cancer metastasis and mortality at the time of diagnosis. J Natl Cancer Inst. 2009;101(12):878–87.PubMedCrossRefGoogle Scholar
  30. 30.
    Stephenson AJ, Kattan MW, Eastham JA, et al. Prostate cancer-specific mortality after radical prostatectomy for patients treated in the prostate-specific antigen era. J Clin Oncol. 2009;27(26): 4300–5.PubMedCrossRefGoogle Scholar
  31. 31.
    Cooperberg MR, Hilton JF, Carroll PR. The CAPRA-S score: a straightforward tool for improved prediction of outcomes after radical prostatectomy. Cancer. 2011;117:5039–46.PubMedCrossRefGoogle Scholar
  32. 32.
    Reese AC, Cooperberg MR, Carroll PR. Minimal impact of clinical stage on prostate cancer prognosis among contemporary patients with clinically localized disease. J Urol. 2010;184(1):114–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Epstein JI, Allsbrook Jr WC, Amin MB, Egevad LL. The 2005 international society of urological pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma. Am J Surg Pathol. 2005;29(9):1228–42.PubMedCrossRefGoogle Scholar
  34. 34.
    Smith EB, Frierson Jr HF, Mills SE, Boyd JC, Theodorescu D. Gleason scores of prostate biopsy and radical prostatectomy specimens over the past 10 years: is there evidence for systematic upgrading? Cancer. 2002;94(8):2282–7.PubMedCrossRefGoogle Scholar
  35. 35.
    Foote J, Yun SK, Leach GE. Post-prostatectomy incontinence: pathology, evaluation, and management. Urol Clin North Am. 1991;18:229.PubMedGoogle Scholar
  36. 36.
    Cooperberg MR, Koppie TM, Lubeck DP, et al. How potent is potent? Evaluation of sexual function and bother in men who report potency after treatment for prostate cancer: data from CaPSURE. Urology. 2003;61(1):190–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Litwin MS, Flanders SC, Pasta DJ, Stoddard ML, Lubeck DP, Henning JM. Sexual function and bother after radical prostatectomy or radiation for prostate cancer: multivariate quality-of-life analysis from CaPSURE. Cancer of the prostate strategic urologic research endeavor. Urology. 1999;54(3):503–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Sonn GA, Sadetsky N, Presti JC, Litwin MS. Differing perceptions of quality of life in patients with prostate cancer and their doctors. J Urol. 2009;182(5):2296–302.PubMedCrossRefGoogle Scholar
  39. 39.
    Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology. 2000;56(6):899–905.PubMedCrossRefGoogle Scholar
  40. 40.
    Wu AK, Cooperberg MR, Sadetsky N, Carroll PR. Health-related quality of life in patients treated with multimodal therapy for prostate cancer. J Urol. 2008;180(6):2415–22; discussion 2422.PubMedCrossRefGoogle Scholar
  41. 41.
    Coyne KS, Zhou Z, Thompson C, Versi E. The impact on health-related quality of life of stress, urge and mixed urinary incontinence. BJU Int. 2003;92(7):731–5.PubMedCrossRefGoogle Scholar
  42. 42.
    Stewart ST, Lenert L, Bhatnagar V, Kaplan RM. Utilities for prostate cancer health states in men aged 60 and older. Med Care. 2005;43(4):347–55.PubMedCrossRefGoogle Scholar
  43. 43.
    Lu-Yao GL, Albertsen PC, Moore DF, et al. Survival following primary androgen deprivation therapy among men with localized prostate cancer. JAMA. 2008;300(2):173–81.PubMedCrossRefGoogle Scholar
  44. 44.
    Wong YN, Mitra N, Hudes G, et al. Survival associated with treatment vs. observation of localized prostate cancer in elderly men. JAMA. 2006;296(22):2683–93.PubMedCrossRefGoogle Scholar
  45. 45.
    Potosky AL, Harlan LC, Stanford JL, et al. Prostate cancer practice patterns and quality of life: the prostate cancer outcomes study. J Natl Cancer Inst. 1999;91(20):1719–24.PubMedCrossRefGoogle Scholar
  46. 46.
    Smith DP, King MT, Egger S, et al. Quality of life three years after diagnosis of localised prostate cancer: population-based cohort study. BMJ. 2009;339:b4817.PubMedCrossRefGoogle Scholar
  47. 47.
    Cooperberg MR, Park S, Carroll PR. Prostate cancer 2004: insights from national disease registries. Oncology (Williston Park). 2004;18(10):1239–47; discussion 1248–50, 1256–8.Google Scholar
  48. 48.
    Cooperberg MR, Broering JM, Latini DM, Litwin MS, Wallace KL, Carroll PR. Patterns of practice in the United States: insights from CaPSURE on prostate cancer management. Curr Urol Rep. 2004;5(3):166–72.PubMedCrossRefGoogle Scholar
  49. 49.
    Hu JC, Wang Q, Pashos CL, Lipsitz SR, Keating NL. Utilization and outcomes of minimally invasive radical prostatectomy. J Clin Oncol. 2008;26(14):2278–84.PubMedCrossRefGoogle Scholar
  50. 50.
    Ficarra V, Novara G, Artibani W, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol. 2009;55(5): 1037–63.PubMedCrossRefGoogle Scholar
  51. 51.
    Schroeck FR, Krupski TL, Sun L, et al. Satisfaction and regret after open retropubic or robot-assisted laparoscopic radical prostatectomy. Eur Urol. 2008;54(4):785–93.PubMedCrossRefGoogle Scholar
  52. 52.
    Hu JC, Gu X, Lipsitz SR, et al. Comparative effectiveness of minimally invasive vs. open radical prostatectomy. JAMA. 2009;302(14): 1557–64.PubMedCrossRefGoogle Scholar
  53. 53.
    Litwin MS, Lubeck DP, Henning JM, Carroll PR. Differences in urologist and patient assessments of health related quality of life in men with prostate cancer: results of the CaPSURE database. J Urol. 1998;159(6):1988–92.PubMedCrossRefGoogle Scholar
  54. 54.
    Spencer BA, Miller DC, Litwin MS, et al. Variations in quality of care for men with early-stage prostate cancer. J Clin Oncol. 2008;26(22):3735–42.PubMedCrossRefGoogle Scholar
  55. 55.
    Barocas DA, Chang SS, Cookson MS. Impact of surgeon and hospital volume on outcomes of radical prostatectomy. Urol Oncol. 2010;28(3):243–50.PubMedCrossRefGoogle Scholar
  56. 56.
    Vickers AJ, Bianco FJ, Serio AM, et al. The surgical learning curve for prostate cancer control after radical prostatectomy. J Natl Cancer Inst. 2007;99(15):1171–7.PubMedCrossRefGoogle Scholar
  57. 57.
    Vickers AJ, Savage CJ, Hruza M, et al. The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study. Lancet Oncol. 2009;10(5):475–80.PubMedCrossRefGoogle Scholar
  58. 58.
    Coelho RF, Rocco B, Patel MB, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a critical review of outcomes reported by high-volume centers. J Endourol. 2010;24(12):2003–15.PubMedCrossRefGoogle Scholar
  59. 59.
    Imperatore V, Cantiello F, Fusco F, et al. Radical perineal prostatectomy versus radical retropubic prostatectomy after previous prostate surgery: surgical and functional outcomes. Urol Int. 2011;86:140–5. Epub 2010 Nov 30.PubMedCrossRefGoogle Scholar
  60. 60.
    Paiva CS, Andreoni C, Cunha GP, Khalil W, Ortiz V. Differences among patients undergoing perineal or retropubic radical prostatectomy in pain and perioperative variables: a prospective study. BJU Int. 2009;104(9):1219–26.PubMedCrossRefGoogle Scholar
  61. 61.
    Boris RS, Kaul SA, Sarle RC, Stricker HJ. Radical prostatectomy: a single surgeon comparison of retropubic, perineal, and robotic approaches. Can J Urol. 2007;14(3):3566–70.PubMedGoogle Scholar
  62. 62.
    Prasad SM, Gu X, Lavelle R, Lipsitz SR, Hu JC. Comparative effectiveness of perineal versus retropubic and minimally invasive radical prostatectomy. J Urol. 2011;185(1):111–5.PubMedCrossRefGoogle Scholar
  63. 63.
    Spencer BA, Steinberg M, Malin J, Adams J, Litwin MS. Quality-of-care indicators for early-stage prostate cancer. J Clin Oncol. 2003;21(10):1928–36.PubMedCrossRefGoogle Scholar
  64. 64.
    Zietman AL, DeSilvio ML, Slater JD, et al. Comparison of conventional-dose vs. high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA. 2005;294(10):1233–9 [Erratum pub 2008; 1299:1898].PubMedCrossRefGoogle Scholar
  65. 65.
    Zietman AL, Bae K, Slater JD, et al. Randomized trial comparing conventional-dose with high-dose conformal radiation therapy in early-stage adenocarcinoma of the prostate: long-term results from proton radiation oncology group/American college of radiology 95–09. J Clin Oncol. 2010;28(7):1106–11.PubMedCrossRefGoogle Scholar
  66. 66.
    Viani GA, Stefano EJ, Afonso SL. Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials. Int J Radiat Oncol Biol Phys. 2009;74(5):1405–18.PubMedCrossRefGoogle Scholar
  67. 67.
    Hummel S, Simpson EL, Hemingway P, Stevenson MD, Rees A. Intensity-modulated radiotherapy for the treatment of prostate cancer: a systematic review and economic evaluation. Health Technol Assess. 2010;14(47):1–108, iii–iv.PubMedGoogle Scholar
  68. 68.
    Shu HK, Lee TT, Vigneauly E, et al. Toxicity following high-dose three-dimensional conformal and intensity-modulated radiation therapy for clinically localized prostate cancer. Urology. 2001;57(1):102–7.PubMedCrossRefGoogle Scholar
  69. 69.
    Kupelian PA, Reddy CA, Klein EA, Willoughby TR. Short-course intensity-modulated radiotherapy (70 GY at 2.5 GY per fraction) for localized prostate cancer: preliminary results on late toxicity and quality of life. Int J Radiat Oncol Biol Phys. 2001;51(4): 988–93.PubMedCrossRefGoogle Scholar
  70. 70.
    Pickles T, Keyes M, Morris WJ. Brachytherapy or conformal external radiotherapy for prostate cancer: a single-institution matched-pair analysis. Int J Radiat Oncol Biol Phys. 2010;76(1):43–9.PubMedCrossRefGoogle Scholar
  71. 71.
    Pinkawa M, Asadpour B, Piroth MD, et al. Health-related quality of life after permanent I-125 brachytherapy and conformal external beam radiotherapy for prostate cancer–a matched-pair comparison. Radiother Oncol. 2009;91(2):225–31.PubMedCrossRefGoogle Scholar
  72. 72.
    Zelefsky MJ, Yamada Y, Pei X, et al. Comparison of tumor control and toxicity outcomes of high-dose intensity-modulated radiotherapy and brachytherapy for patients with favorable risk prostate cancer. Urology. 2011;77:986–90. Epub 2010 Dec 31.PubMedCrossRefGoogle Scholar
  73. 73.
    Jabbari S, Weinberg VK, Shinohara K, et al. Equivalent biochemical control and improved prostate-specific antigen nadir after permanent prostate seed implant brachytherapy versus high-dose three-dimensional conformal radiotherapy and high-dose conformal proton beam radiotherapy boost. Int J Radiat Oncol Biol Phys. 2010;76(1):36–42.PubMedCrossRefGoogle Scholar
  74. 74.
    Hermesse J, Biver S, Jansen N, Lenaerts E, Nickers P. Dosimetric comparison of high-dose-rate brachytherapy and intensity-modu lated radiation therapy as a boost to the prostate. Int J Radiat Oncol Biol Phys. 2010;76(1):269–76.PubMedCrossRefGoogle Scholar
  75. 75.
    Pickett B, Kurhanewicz J, Pouliot J, et al. Three-dimensional conformal external beam radiotherapy compared with permanent prostate implantation in low-risk prostate cancer based on endorectal magnetic resonance spectroscopy imaging and prostate-specific antigen level. Int J Radiat Oncol Biol Phys. 2006;65(1):65–72.PubMedCrossRefGoogle Scholar
  76. 76.
    Pieters BR, de Back DZ, Koning CC, Zwinderman AH. Comparison of three radiotherapy modalities on biochemical control and overall survival for the treatment of prostate cancer: a systematic review. Radiother Oncol. 2009;93(2):168–73.PubMedCrossRefGoogle Scholar
  77. 77.
    Speight JL, Elkin EP, Pasta DJ, et al. Longitudinal assessment of changes in sexual function and bother in patients treated with external beam radiotherapy or brachytherapy, with and without neoadjuvant androgen ablation: data from CaPSURE. Int J Radiat Oncol Biol Phys. 2004;60(4):1066–75.PubMedCrossRefGoogle Scholar
  78. 78.
    Stock RG. High-dose-rate versus low-dose-rate monotherapy in the treatment of localized prostate cancer: the case for low-dose-rate monotherapy. Brachytherapy. 2006;5(1):5–6; discussion 8.PubMedCrossRefGoogle Scholar
  79. 79.
    Konski A, Speier W, Hanlon A, Beck JR, Pollack A. Is proton beam therapy cost effective in the treatment of adenocarcinoma of the prostate? J Clin Oncol. 2007;25(24):3603–8.PubMedCrossRefGoogle Scholar
  80. 80.
    Potosky AL, Davis WW, Hoffman RM, et al. Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst. 2004;96(18):1358–67.PubMedCrossRefGoogle Scholar
  81. 81.
    Wei JT, Dunn RL, Sandler HM, et al. Comprehensive comparison of health-related quality of life after contemporary therapies for localized prostate cancer. J Clin Oncol. 2002;20(2):557–66.PubMedCrossRefGoogle Scholar
  82. 82.
    Huyghe E, Delannes M, Wagner F, et al. Ejaculatory function after permanent 125I prostate brachytherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2009;74(1):126–32.PubMedCrossRefGoogle Scholar
  83. 83.
    Lilleby W, Fossa SD, Waehre HR, Olsen DR. Long-term morbidity and quality of life in patients with localized prostate cancer undergoing definitive radiotherapy or radical prostatectomy. Int J Radiat Oncol Biol Phys. 1999;43(4):735–43.PubMedCrossRefGoogle Scholar
  84. 84.
    Kattan MW, Eastham JA, Stapleton AM, Wheeler TM, Scardino PT. A preoperative nomogram for disease recurrence following radical prostatectomy for prostate cancer. J Natl Cancer Inst. 1998;90(10):766–71.PubMedCrossRefGoogle Scholar
  85. 85.
    Greene KL, Meng MV, Elkin EP, et al. Validation of the Kattan preoperative nomogram for prostate cancer recurrence using a community based cohort: results from cancer of the prostate strategic urological research endeavor (CaPSURE). J Urol. 2004;171(6, Part 1):2255–9.PubMedCrossRefGoogle Scholar
  86. 86.
    Cooperberg MR, Pasta DJ, Elkin EP, et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol. 2005;173(6):1938–42.PubMedCrossRefGoogle Scholar
  87. 87.
    Cooperberg MR, Vickers AJ, Broering JM, Carroll PR. Comparative risk-adjusted mortality outcomes after primary surgery, radiotherapy, or androgen-deprivation therapy for localized prostate cancer. Cancer. 2010;116(22):5226–34.PubMedCrossRefGoogle Scholar
  88. 88.
    Zelefsky MJ, Eastham JA, Cronin AM, et al. Metastasis after radical prostatectomy or external beam radiotherapy for patients with clinically localized prostate cancer: a comparison of clinical cohorts adjusted for case mix. J Clin Oncol. 2010;28:1508.PubMedCrossRefGoogle Scholar
  89. 89.
    Crook J, Ludgate C, Malone S, et al. Final report of multicenter Canadian phase III randomized trial of 3 versus 8 months of neoadjuvant androgen deprivation therapy before conventional-dose radiotherapy for clinically localized prostate cancer. Int J Radiat Oncol Biol Phys. 2009;73(2):327–33.PubMedCrossRefGoogle Scholar
  90. 90.
    Horwitz EM, Bae K, Hanks GE, et al. Ten-year follow-up of radiation therapy oncology group protocol 92–02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol. 2008;26(15):2497–504.PubMedCrossRefGoogle Scholar
  91. 91.
    Stephenson A, Klein E, Ciezki J, et al. Overall and cancer-specific survival following definitive therapy for clinically localized prostate cancer in the prostate-specific antigen era. J Urol. 2010;183(4(S)):Abstract 285.Google Scholar
  92. 92.
    Miller DC, Gruber SB, Hollenbeck BK, Montie JE, Wei JT. Incidence of initial local therapy among men with lower-risk prostate cancer in the United States. J Natl Cancer Inst. 2006;98(16):1134–41.PubMedCrossRefGoogle Scholar
  93. 93.
    Klotz L, Zhang L, Lam A, Nam R, Mamedov A, Loblaw A. Clinical results of long-term follow-up of a large, active surveillance cohort with localized prostate cancer. J Clin Oncol. 2010;28(1):126–31.PubMedCrossRefGoogle Scholar
  94. 94.
    Warlick C, Trock BJ, Landis P, Epstein JI, Carter HB. Delayed versus immediate surgical intervention and prostate cancer outcome. J Natl Cancer Inst. 2006;98(5):355–7.PubMedCrossRefGoogle Scholar
  95. 95.
    Newcomb LF, Brooks JD, Carroll PR, et al. Canary prostate active surveillance study: design of a multi-institutional active surveillance cohort and biorepository. Urology. 2010;75(2):407–13.PubMedCrossRefGoogle Scholar
  96. 96.
    Cooperberg MR, Carroll PR, Klotz L. Active surveillance for prostate cancer: progress and promise. J Clin Oncol. 2011;29(27):3669–76.PubMedCrossRefGoogle Scholar
  97. 97.
    Cooperberg MR, Cowan JE, Hilton JF, et al. Outcomes of active surveillance for men with intermediate-risk prostate cancer. J Clin Oncol. 2011;29:228–34.PubMedCrossRefGoogle Scholar
  98. 98.
    Bill-Axelson A, Holmberg L, Filen F, et al. Radical prostatectomy versus watchful waiting in localized prostate cancer: the Scandinavian prostate cancer group-4 randomized trial. J Natl Cancer Inst. 2008;100(16):1144–54.PubMedCrossRefGoogle Scholar
  99. 99.
    Hayes JH, Ollendorf DA, Pearson SD, et al. Active surveillance compared with initial treatment for men with low-risk prostate cancer: a decision analysis. JAMA. 2010;304(21):2373–80.PubMedCrossRefGoogle Scholar
  100. 100.
    Cooper MM, Birkmeyer JD, Bronner KK, et al. The quality of medical care in the United States: a report on the Medicare program. Hanover: The Center for the Evaluative Clinical Sciences, Dartmouth Medical School; 1999.Google Scholar
  101. 101.
    Konety BR, Cowan JE, Carroll PR. Patterns of primary and secondary therapy for prostate cancer in elderly men: analysis of data from CaPSURE. J Urol. 2008;179(5):1797–803; discussion 1803.PubMedCrossRefGoogle Scholar
  102. 102.
    Fitzpatrick JM. Management of localized prostate cancer in senior adults: the crucial role of comorbidity. BJU Int. 2008;101 Suppl 2:16–22.PubMedCrossRefGoogle Scholar
  103. 103.
    Alibhai SM, Naglie G, Nam R, Trachtenberg J, Krahn MD. Do older men benefit from curative therapy of localized prostate cancer? J Clin Oncol. 2003;21(17):3318–27.PubMedCrossRefGoogle Scholar
  104. 104.
    Bechis SK, Carroll PR, Cooperberg MR. Impact of age at diagnosis on prostate cancer treatment and survival. J Clin Oncol. 2011;29(2):235–41.PubMedCrossRefGoogle Scholar
  105. 105.
    Jang TL, Bekelman JE, Liu Y, et al. Physician visits prior to treatment for clinically localized prostate cancer. Arch Intern Med. 2010;170(5):440–50.PubMedCrossRefGoogle Scholar
  106. 106.
    Thompson TC, Yang G. Regulation of apoptosis in prostatic disease. Prostate Suppl. 2000;9:25–8.PubMedCrossRefGoogle Scholar
  107. 107.
    Fleshner N, Rakovitch E, Klotz L. Differences between urologists in the United States and Canada in the approach to prostate cancer. J Urol. 2000;163(5):1461–6.PubMedCrossRefGoogle Scholar
  108. 108.
    Bubolz T, Wasson JH, Lu-Yao G, Barry MJ. Treatments for prostate cancer in older men: 1984–1997. Urology. 2001;58(6):977–82.PubMedCrossRefGoogle Scholar
  109. 109.
    Schwartz KL, Alibhai SM, Tomlinson G, Naglie G, Krahn MD. Continued undertreatment of older men with localized prostate cancer. Urology. 2003;62(5):860–5.PubMedCrossRefGoogle Scholar
  110. 110.
    Lu-Yao GL, Albertsen PC, Moore DF, et al. Outcomes of localized prostate cancer following conservative management. JAMA. 2009;302(11):1202–9.PubMedCrossRefGoogle Scholar
  111. 111.
    Fowler Jr FJ, McNaughton Collins M, Albertsen PC, Zietman A, Elliott DB, Barry MJ. Comparison of recommendations by urologists and radiation oncologists for treatment of clinically localized prostate cancer. JAMA. 2000;283(24):3217–22.PubMedCrossRefGoogle Scholar
  112. 112.
    Shao YH, Demissie K, Shih W, et al. Contemporary risk profile of prostate cancer in the United States. J Natl Cancer Inst. 2009;101(18):1280–3.PubMedCrossRefGoogle Scholar
  113. 113.
    Penson DF, Schonfeld WH, Flanders SC, et al. Relationship of first-year costs of treating localized prostate cancer to initial choice of therapy and stage at diagnosis: results from the CaPSURE database. Urology. 2001;57(3):499–503.PubMedCrossRefGoogle Scholar
  114. 114.
    Wilson LS, Tesoro R, Elkin EP, et al. Cumulative cost pattern comparison of prostate cancer treatments. Cancer. 2007;109(3):518–27.PubMedCrossRefGoogle Scholar
  115. 115.
    Bolenz C, Gupta A, Hotze T, et al. Cost comparison of robotic, laparoscopic, and open radical prostatectomy for prostate cancer. Eur Urol. 2010;57(3):453–8.PubMedCrossRefGoogle Scholar
  116. 116.
    Bolenz C, Gupta A, Hotze T, et al. The influence of body mass index on the cost of radical prostatectomy for prostate cancer. BJU Int. 2010;106(8):1188–93.PubMedCrossRefGoogle Scholar
  117. 117.
    Gianino MM, Galzerano M, Tizzani A, Gontero P. Critical issues in current comparative and cost analyses between retropubic and robotic radical prostatectomy. BJU Int. 2008;101(1):2–3.PubMedGoogle Scholar
  118. 118.
    Peeters A, Grutters JP, Pijls-Johannesma M, et al. How costly is particle therapy? Cost analysis of external beam radiotherapy with carbon-ions, protons and photons. Radiother Oncol. 2010;95(1):45–53.PubMedCrossRefGoogle Scholar
  119. 119.
    Satoh T, Ishiyama H, Matsumoto K, et al. Cost comparison of curative therapies for localized prostate cancer in Japan: a single-institution experience. Jpn J Radiol. 2009;27(9):348–54.PubMedCrossRefGoogle Scholar
  120. 120.
    Arcangeli G, Saracino B, Gomellini S, et al. A prospective phase III randomized trial of hypofractionation versus conventional fractionation in patients with high-risk prostate cancer. Int J Radiat Oncol Biol Phys. 2010;78(1):11–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Department of UrologyUCSF Helen Diller Family Comprehensive Cancer CenterSan FranciscoUSA

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