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 an d nature of the trend toward increased use of radical prostatectomy fo r 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 locat ed throughout the United States. Data from this resource on 4,531 pati ents treated in 1985, 25,028 treated in 1988, and 21,697 treated in 19 90 were reviewed. Results. The data indicate that selection of radical prostatectomy increased markedly over this interval. Use of radical p rostatectomy was greatest in younger men in every year studied. The pr oportion of patients treated by radical prostatectomy was greatest in the western United States and least in New England and the mid-Atlanti c region. Radical prostatectomy was associated with patients' socioeco nomic status and race as well as with the hospital's caseload of patie nts with cancer. Conclusions. The pattern of care for localized prosta te cancer is changing significantly. Further research is needed to ass ess whether these variations reflect differences in access to care or patterns of patient preference.