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Characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer()

BACKGROUND: We sought to determine temporal trends in the receipt of prostatectomy or locoregional radiation to the prostate for patients with metastatic prostate cancer and to identify predictors of receipt of local treatment. METHODS: We identified 39,976 patients with metastatic prostate cancer d...

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Autores principales: Sinha, Sumi, Muralidhar, Vinayak, Feng, Felix Y., Nguyen, Paul L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asian Pacific Prostate Society 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551914/
https://www.ncbi.nlm.nih.gov/pubmed/28828351
http://dx.doi.org/10.1016/j.prnil.2017.04.003
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author Sinha, Sumi
Muralidhar, Vinayak
Feng, Felix Y.
Nguyen, Paul L.
author_facet Sinha, Sumi
Muralidhar, Vinayak
Feng, Felix Y.
Nguyen, Paul L.
author_sort Sinha, Sumi
collection PubMed
description BACKGROUND: We sought to determine temporal trends in the receipt of prostatectomy or locoregional radiation to the prostate for patients with metastatic prostate cancer and to identify predictors of receipt of local treatment. METHODS: We identified 39,976 patients with metastatic prostate cancer diagnosed in 2004–2012 using the National Cancer Database (NCDB). We used logistic multivariable regression to determine trends in the receipt of prostate and/or pelvic radiation or radical prostatectomy after adjusting for demographic and clinical factors. RESULTS: Patients with metastatic disease were less likely to receive locoregional treatment over time [7.88% in 2004 vs. 5.53% in 2012, adjusted odds ratio (AOR) = 0.97 per year, 95% confidence interval (CI) = 0.95–0.98; P < 0.001]. Cofactors associated with decreased likelihood for locoregional treatment included older age (AOR = 0.96 per year, 95% CI = 0.96–0.96, P < 0.001) and increased comorbidity level (1 comorbidity: AOR = 0.82, 95% CI = 0.73–0.93, P = 0.001; two or more comorbidities: AOR = 0.49, 95% CI = 0.39–0.61, P < 0.001). Decreasing utilization of both radiation and surgery of the primary site contributed to this trend. More specifically, patients with metastatic disease were less likely to receive radiation to the prostate and/or pelvis over time (5.9% in 2004 vs. 4.2% in 2012, AOR = 0.97 per year, 95% CI = 0.95–0.99, P < 0.001). Similarly, there was a trend toward decreased use of radical prostatectomy (2.17% in 2004 compared to 1.31% in 2012, AOR = 0.96 per year, 95% CI 0.93–0.99, P = 0.01). CONCLUSION: Despite recent evidence of the possible benefit for locoregional treatment of prostate cancer in the setting of metastatic disease, rates of prostate radiation and radical prostatectomy among this population have actually declined over the 8-year period between 2004 and 2012, suggesting slow adoption of this novel treatment paradigm.
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spelling pubmed-55519142017-08-21 Characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer() Sinha, Sumi Muralidhar, Vinayak Feng, Felix Y. Nguyen, Paul L. Prostate Int Original Article BACKGROUND: We sought to determine temporal trends in the receipt of prostatectomy or locoregional radiation to the prostate for patients with metastatic prostate cancer and to identify predictors of receipt of local treatment. METHODS: We identified 39,976 patients with metastatic prostate cancer diagnosed in 2004–2012 using the National Cancer Database (NCDB). We used logistic multivariable regression to determine trends in the receipt of prostate and/or pelvic radiation or radical prostatectomy after adjusting for demographic and clinical factors. RESULTS: Patients with metastatic disease were less likely to receive locoregional treatment over time [7.88% in 2004 vs. 5.53% in 2012, adjusted odds ratio (AOR) = 0.97 per year, 95% confidence interval (CI) = 0.95–0.98; P < 0.001]. Cofactors associated with decreased likelihood for locoregional treatment included older age (AOR = 0.96 per year, 95% CI = 0.96–0.96, P < 0.001) and increased comorbidity level (1 comorbidity: AOR = 0.82, 95% CI = 0.73–0.93, P = 0.001; two or more comorbidities: AOR = 0.49, 95% CI = 0.39–0.61, P < 0.001). Decreasing utilization of both radiation and surgery of the primary site contributed to this trend. More specifically, patients with metastatic disease were less likely to receive radiation to the prostate and/or pelvis over time (5.9% in 2004 vs. 4.2% in 2012, AOR = 0.97 per year, 95% CI = 0.95–0.99, P < 0.001). Similarly, there was a trend toward decreased use of radical prostatectomy (2.17% in 2004 compared to 1.31% in 2012, AOR = 0.96 per year, 95% CI 0.93–0.99, P = 0.01). CONCLUSION: Despite recent evidence of the possible benefit for locoregional treatment of prostate cancer in the setting of metastatic disease, rates of prostate radiation and radical prostatectomy among this population have actually declined over the 8-year period between 2004 and 2012, suggesting slow adoption of this novel treatment paradigm. Asian Pacific Prostate Society 2017-09 2017-04-18 /pmc/articles/PMC5551914/ /pubmed/28828351 http://dx.doi.org/10.1016/j.prnil.2017.04.003 Text en © 2017 Asian Pacific Prostate Society, Published by Elsevier Korea LLC. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Sinha, Sumi
Muralidhar, Vinayak
Feng, Felix Y.
Nguyen, Paul L.
Characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer()
title Characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer()
title_full Characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer()
title_fullStr Characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer()
title_full_unstemmed Characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer()
title_short Characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer()
title_sort characteristics and national trends of patients receiving treatment of the primary tumor for metastatic prostate cancer()
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551914/
https://www.ncbi.nlm.nih.gov/pubmed/28828351
http://dx.doi.org/10.1016/j.prnil.2017.04.003
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