Abstract
Objective
To analyze national trends using the National Cancer Database (NCDB) in use of androgen
deprivation therapy (ADT), outside of standard of care, in patients with very low
risk prostate cancer.
Methods
We identified 52,797 men in the NCDB from 2010 to 2015 diagnosed with very low risk
prostate cancer as defined (cT1cM0, PSA <10, Gleason ≤6, <3 biopsy cores positive).
We evaluated the treatment trends and the proportion of men treated with ADT based
on race, income, insurance status, treatment facility volume, and Charlson comorbidity.
Results
From 2010 to 2015, prevalence of primary ADT use in patients with very low risk prostate
cancer remained 0.7%. Patients treated at low-volume facilities were more likely to
receive primary ADT (hazard ratio [HR] 1.29, P <.001) as were black patients (HR 1.47, P <.001). When evaluated over time, the proportion of men treated with primary ADT
who were white decreased while the proportion of men who were black increased.
Conclusion
The use of primary ADT in men with very low risk prostate cancer has not changed over
time, and may be over utilized, particularly among black men and those treated at
low-volume facilities.
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Article info
Publication history
Published online: April 29, 2019
Accepted:
February 6,
2019
Received:
December 7,
2018
Identification
Copyright
© 2019 Published by Elsevier Inc.
