Trends in treatment of localized prostate cancer by radical prostatectomy: observations from the Commission on Cancer National Cancer Database, 1985-1990.

OBJECTIVE

Tumor registry data were studied to assess the magnitude and nature of the trend toward increased use of radical prostatectomy for the treatment of newly diagnosed localized prostate cancer.

METHODS

The Commission on Cancer of the American College of Surgeons National Cancer Data Base aggregates data from hospital tumor registries located throughout the United States. Data from this resource on 4,531 patients treated in 1985, 25,028 treated in 1988, and 21,697 treated in 1990 were reviewed.

RESULTS

The data indicate that selection of radical prostatectomy increased markedly over this interval. Use of radical prostatectomy was greatest in younger men in every year studied. The proportion of patients treated by radical prostatectomy was greatest in the western United States and least in New England and the mid-Atlantic region. Radical prostatectomy was associated with patients' socioeconomic status and race as well as with the hospital's caseload of patients with cancer.

CONCLUSIONS

The pattern of care for localized prostate cancer is changing significantly. Further research is needed to assess whether these variations reflect differences in access to care or patterns of patient preference.