779 POPULATION-BASED ASSESSMENT OF CHEMOTHERAPY-RELATED ADVERSE EFFECTS AND HOSPITALIZATIONS FROM CHEMOTHERAPY IN MEN WITH METASTATIC PROSTATE CANCER

Abstract

INTRODUCTION AND OBJECTIVES: While chemotherapy may be given for androgen insensitive prostate cancer, little is know about population-based patterns of care and outcomes beyond reports from academic centers. The objective of our study is to assess temporal trends in the use and outcomes chemotherapy for metastatic prostate cancer using SEER-Medicare linked data. METHODS: We examined of 8,958 men diagnosed with metastatic prostate cancer aged 66 from 1992 through 2007 were identified from the SEER-Medicare linked program were examined. Use of chemotherapy was identified with Current Procedural Classification 4th Edition codes, and frequency and diagnosis during emergency room and hospital admissions were assessed. Patients were defined as being hospitalized for adverse effects of chemotherapy if there was a Medicare inpatient claim for neutropenia, fever, thrombocytopenia, or adverse effect within 12 8 months after their diagnosis of prostate cancer. RESULTS: Overall, 2389 (36%) men with metastatic prostate cancer received chemotherapy, and utilization of chemotherapy increased from 11.92% in 1992 to 30.85% in 2007, peaking at 35.19% in 2005. Men who received chemotherapy were less likely to have had radiation therapy (41.37% vs. 58.63%) or androgen deprivation therapy (33.26% vs. 66.74%) compared to men who did not undergo chemotherapy (p 0.001). Readmissions due neutropenia, fever, thrombocytopenia, occurred in 53.01% of men receiving chemotherapy compared with 15% of men who did not receive chemotherapy. Greater comorbidity and geographic variation was associated with more hospital readmissions. CONCLUSIONS: While the use of chemotherapy for metastatic prostate cancer increased during the study period, adverse events occurred relatively frequently resulting in a more than 3 fold risk for readmissions.