PD15-07 PROSTATE BRACHYTHERAPY CASE VOLUME IN THE COMMUNITY SETTING DOES NOT AFFECT ONCOLOGIC OUTCOMES

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD15-07 PROSTATE BRACHYTHERAPY CASE VOLUME IN THE COMMUNITY SETTING DOES NOT AFFECT ONCOLOGIC OUTCOMES Kevin Chang, Lufan Wang, Janet Cowan, Osama Mohamad, Peter Carroll, and Matthew Cooperberg Kevin ChangKevin Chang More articles by this author , Lufan WangLufan Wang More articles by this author , Janet CowanJanet Cowan More articles by this author , Osama MohamadOsama Mohamad More articles by this author , Peter CarrollPeter Carroll More articles by this author , and Matthew CooperbergMatthew Cooperberg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003262.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer brachytherapy (BT) is a treatment modality that has been declining in usage. The goal of this study is to describe the relationship between facility BT case volume and cancer-specific outcomes in patients with localized prostate cancer (PCa). METHODS: We identified patients in CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) diagnosed with localized PCa between 1999-2007 and treated with BT. Only community sites had sufficient recorded cases for inclusion. BT case volume of each facility was based on its number of BT-treated PCa patients, with those above the 75th percentile categorized as high-volume. Our primary outcome is the effect of case volume on biochemical failure based on the Phoenix definition or receipt of salvage treatment after primary BT to account for a large proportion of missing PSA follow-up values in our cohort. Secondary outcomes included patient-reported UCLA Prostate Cancer Index scores for urinary, sexual, and bowel function and bother. RESULTS: We identified 1,282 BT-treated patients with localized PCa with median follow-up of 9 years (3.8 years based on last PSA) across 18 community sites with a median of 210 BT cases. Overall, 92% of patients were National Comprehensive Cancer Network low- or intermediate-risk and 98% received low dose rate BT. 722 patients (56.3%) received BT at high-volume (>210 cases) community facilities and 560 patients (43.7%) at low-volume (10-210 cases) facilities. High-volume facilities predominantly used Pd-103 seeds while low-volume facilities predominantly used I-125 seeds (p<0.01). A greater proportion of patients at low-volume facilities had pre-BT hormone therapy (p<0.01). High-volume facility status was not associated with improved rates of biochemical failure (10-year cumulative incidence 10.3% vs 12.5%, log-rank p=0.27, Figure 1A) or prostate cancer specific mortality (10-year cumulative incidence 4.0% vs 4.5%, log-rank p=0.62). Patient-reported scores of urinary, sexual, and bowel bother at 6 months following BT were comparable (Figure 1B). CONCLUSIONS: BT-treated patients with localized PCa at high-volume community facilities have similar rates of biochemical failure, prostate cancer specific mortality, and trends in quality of life outcomes compared to those treated at low-volume community facilities. Source of Funding: UCSF Goldberg-Benioff Program in Translational Cancer Biology © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e421 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Chang More articles by this author Lufan Wang More articles by this author Janet Cowan More articles by this author Osama Mohamad More articles by this author Peter Carroll More articles by this author Matthew Cooperberg More articles by this author Expand All Advertisement PDF downloadLoading ...