A population-based study on management of prostate cancer in four regions of France

In France, as in other European countries, management of prostate cancer in the population is rather variable. The objective was to analyse diagnosis and treatment modalities, of prostate cancer in patients, from French cance r registries. A sample of 803 patients with prostate cancer diagnosed in 19 95 was drawn at random from cases recorded in four cancer registries in the geographical regions of Bas-Rhin, Calvados, Isere and Tam. Diagnosis, clin ical staging and treatment were analysed by questionnaire. Multivariate ana lysis by logistic regression was, used to describe medical determinants (ag e, PSA, clinical staging) of the various treatment choices. The mean age of the patients was 71.6 y (range 46-94 y). Clinical staging s howed 60% T1-2 tumours, 15% T3-4 and 17% N + or metastases. PSA rate (media n 18.2 ng/ml) was assessed in 92.4% of patients. Prostate cancer was diagno sed by prostate biopsy in 63% and by transurethral resection of the prostat e (TURP) in 32% of patients. The main treatments were radical prostatectomy 22%, radiotherapy 19.4%, hormonal therapy 33%, TURP alone 17.7% and expect ant management 6%. The method of treatment was unknown in 5.7% of cases. Ad juvant radiotherapy or hormonal therapy had been used in 31% of cases. Logi stic regression analysis showed that radical prostatectomy was most often p erformed in patients aged <60 y, three times more frequently for T-2 tumour and for PSA between 4 and 20 ng/ml. Radiotherapy was the most frequently a pplied treatment for patients aged between 65 and 75 y, especially in T-3 t umours. Approximately 75% of the patients in the study underwent a specific treatme nt for prostate cancer with a curative intention in 40%. This study provide s a baseline to clinicians and public health authorities on the management of prostate cancer in France with recent data. This survey will be useful t o compare future descriptive analysis and to provide data regarding changin g clinical practice.