Skip Navigation

JNCI Journal of the National Cancer Institute 2006 98(16):1134-1141; doi:10.1093/jnci/djj308
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (28)
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Miller, D. C.
Right arrow Articles by Wei, J. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Miller, D. C.
Right arrow Articles by Wei, J. T.
Related Collections
Right arrowCorrespondence about this Article
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2006. Published by Oxford University Press.

ARTICLE

Incidence of Initial Local Therapy Among Men With Lower-Risk Prostate Cancer in the United States

David C. Miller, Stephen B. Gruber, Brent K. Hollenbeck, James E. Montie, John T. Wei

Affiliations of authors: Departments of Urology (DCM, BKH, JEM, JTW), Internal Medicine (SBG), Epidemiology (SBG), and Human Genetics (SBG), University of Michigan, Ann Arbor, MI

Correspondence to: John T. Wei, MD, MS, Department of Urology, Taubman Health Care Center, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0330 (e-mail: jtwei{at}umich.edu).

Background: The frequently indolent nature of early-stage prostate cancer in older men and in men with low- or moderate-grade tumors and the demonstration that the survival benefits of radical prostatectomy are primarily among men younger than 65 years have led to concerns about prostate cancer overtreatment. Methods: Using data from 13 Surveillance, Epidemiology, and End Results registries, we performed a retrospective cohort study of 71 602 men who were diagnosed with localized or regional prostate cancer between 2000 and 2002. We quantified the incidence of initial curative therapy (i.e., surgery or radiation therapy) among men with lower-risk cancers as defined by their limited likelihood of either dying from expectantly managed prostate cancer or achieving a survival benefit from local therapy. Stratified analyses and multinomial logistic regression models were used to quantify the absolute and relative rates of curative therapy among men in various age–grade strata. All statistical tests were two-sided. Results: We identified 24 405 men with lower-risk prostate cancers and complete data for the first course of treatment. Initial curative therapy was undertaken in 13 537 of these men (55%); 81% of treated men received radiation therapy. The likelihood of curative therapy, relative to expectant management, varied statistically significantly among lower-risk age–grade strata (all P<.05). Assuming that initial expectant management is appropriate for all lower-risk cancers, 2564 men (10%) in this population-based sample were overtreated with radical prostatectomy and 10 973 (45%) with radiation therapy. Conclusions: These data quantify a target population for whom greater use of expectant approaches may reduce overtreatment and improve the quality of localized prostate cancer care.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?

Correspondence about this Article

Re: Incidence of Initial Local Therapy Among Men With Lower-Risk Prostate Cancer in the United States
Bhadrasain Vikram
J Natl Cancer Inst 2006 98: 1826. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Jpn J Clin OncolHome page
N. Soga, K. Arima, and Y. Sugimura
Undetectable Level of Prostate Specific Antigen (PSA) Nadir Predicts PSA Biochemical Failure in Local Prostate Cancer with Delayed-combined Androgen Blockade
Jpn. J. Clin. Oncol., September 1, 2008; 38(9): 617 - 622.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
M. J. Barry, D. S. Kaufman, and C.-L. Wu
Case 15-2008 -- A 55-Year-Old Man with an Elevated Prostate-Specific Antigen Level and Early-Stage Prostate Cancer
N. Engl. J. Med., May 15, 2008; 358(20): 2161 - 2168.
[Full Text] [PDF]

Home page
 JCOHome page
R. W. Ross and P. W. Kantoff
Predicting Outcomes in Prostate Cancer: How Many More Nomograms Do We Need?
J. Clin. Oncol., August 20, 2007; 25(24): 3563 - 3564.
[Full Text] [PDF]

Home page
 JCOHome page
N. J. Meropol and K. A. Schulman
Cost of Cancer Care: Issues and Implications
J. Clin. Oncol., January 10, 2007; 25(2): 180 - 186.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
B. Vikram
Re: Incidence of Initial Local Therapy Among Men With Lower-Risk Prostate Cancer in the United States
J Natl Cancer Inst, December 20, 2006; 98(24): 1826 - 1826.
[Full Text] [PDF]

Home page
 JAMAHome page
M. S. Litwin and D. C. Miller
Treating Older Men With Prostate Cancer: Survival (or Selection) of the Fittest?
JAMA, December 13, 2006; 296(22): 2733 - 2734.
[Full Text] [PDF]

Home page
 JWatch GeneralHome page
Aggressive Approach to Prostate Cancer Among Older Men
Journal Watch (General), September 14, 2006; 2006(914): 1 - 1.
[Full Text]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.