Prostate cancer treatment modalities and survival outcomes: a comparative analysis of Falmouth Hospital versus Massachusetts and nationwide hospitals.

Treatment of clinically localized prostate cancer has been termed a model of "preference-sensitive" health care. Because there is no documented consensus supporting any one of the primary treatment modalities-surgery, external beam radiation, and brachytherapy-over the others, patient and physician preferences can significantly influence treatment approach. This can lead to substantial variation in treatment practices at the level of individual hospitals. In this context, it is informative for individual hospitals, especially small community hospitals that lack substantial quality assurance resources, to compare their prostate cancer care to that provided by cohort groups of hospitals. This study compares prostate cancer treatment modalities at Falmouth Hospital (FH), a 95-bed community hospital located in Falmouth, Massachusetts, to those at hospitals in 3 cohort groups: 1) US hospitals of all types, 2) Massachusetts hospitals of all types, and 3) Massachusetts community hospitals. It also compares survival outcomes for FH prostate cancer patients to national averages. All data for these comparisons were obtained from the National Cancer Data Base (NCDB) Hospital Comparison Benchmark Reports and Survival Reports applications. This study's main finding is that FH performed markedly less surgery and more radiation, specifically brachytherapy, than the cohort groups of hospitals. This distribution of treatment modalities was not solely attributable to FH's older than average patient population. Studies similar to this one could be conducted by other community hospitals to inform quality assessment programs for prostate cancer care.