PD28-07 ASSESSMENT OF THE RATE OF ADHERENCE TO INTERNATIONAL GUIDELINES OF ANDROGEN DEPRIVATION THERAPY WITH EXTERNAL BEAM RADIATION THERAPY- A POPULATION-BASED STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) I1 Apr 2016PD28-07 ASSESSMENT OF THE RATE OF ADHERENCE TO INTERNATIONAL GUIDELINES OF ANDROGEN DEPRIVATION THERAPY WITH EXTERNAL BEAM RADIATION THERAPY- A POPULATION-BASED STUDY Paolo Dell’Oglio, Hiba Abou-Haidar, Sami-Ramzi Leyh-Bannurah, Zhe Tian, Giorgio Gandaglia, Shahrokh Shariat, Umberto Capitanio, Alberto Briganti, Francesco Montorsi, Markus Graefen, Fred Saad, and Pierre Karakiewicz Paolo Dell’OglioPaolo Dell’Oglio More articles by this author , Hiba Abou-HaidarHiba Abou-Haidar More articles by this author , Sami-Ramzi Leyh-BannurahSami-Ramzi Leyh-Bannurah More articles by this author , Zhe TianZhe Tian More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Shahrokh ShariatShahrokh Shariat More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Markus GraefenMarkus Graefen More articles by this author , Fred SaadFred Saad More articles by this author , and Pierre KarakiewiczPierre Karakiewicz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.394AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The National Comprehensive Cancer Network and the European Association of Urology guidelines recommend using radiation therapy with androgen deprivation therapy (RT-ADT) for the treatment of high-risk localized prostate cancer and locally advanced prostate cancer patients. The objective of the current study was to examine the rate of adherence to these guidelines within a large-scale population-based data repository. We hypothesized near-perfect guideline adherence. METHODS Between 2003 and 2009, in the Surveillance Epidemiology and End Results (SEER)-Medicare database, 14,180 patients were diagnosed with high-risk (T1-T2 with WHO histological grade 3), or locally advanced (T3-T4) prostatic adenocarcinoma. We assessed the annual rates of adherence to guidelines with respect to use of RT-ADT in the overall population and after stratification according to stage-grade groupings (T1-T2 G3 vs. T3-T4 any grade), age (66-69 vs. 70-74 vs. 75-79 vs. ≥80), Charlson comorbidity index-CCI (0 vs. 1 vs. ≥2) and pre-existing baseline cardiovascular (CV) risk. Linear regression model was used to test the slope of rates of combination treatment over time. Multivariate logistic regression analyses were performed to assess the predictors of RT-ADT use. RESULTS RT-ADT rates, and guideline adherence, were 58.1 to 75.0%, with the highest rate (75.0%) in 2003, and the lowest (58.1%) in 2009. When stratified according to stage-grade groupings, age, CCI and pre-existing baseline CV risk, similar results were obtained. In multivariate analyses, more recent year of diagnosis (OR 0.90, p<0.001), younger patients (OR 1.03; p<0.001), stages T1-T2 G3 disease (OR 0.35, p<0.001), CCI of 0 (OR 0.87, p=0.007), African-American race (OR 0.85, p=0.004), high socioeconomic status (OR 0.90, p=0.009), unknown marital status (OR 0.77, p<0.001), urban residence (OR 0.64, p<0.001), and residence in the Midwest, South, and West (OR 0.51, OR 0.63, OR 0.60, respectively; all p<0.001) were associated with lower RT-ADT use. CONCLUSIONS The rate of guideline adherence regarding the use of RT-ADT is suboptimal and decreases with time instead of increasing. Moreover, individual patient characteristics indicate random variability. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e656-e657 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Paolo Dell’Oglio More articles by this author Hiba Abou-Haidar More articles by this author Sami-Ramzi Leyh-Bannurah More articles by this author Zhe Tian More articles by this author Giorgio Gandaglia More articles by this author Shahrokh Shariat More articles by this author Umberto Capitanio More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Markus Graefen More articles by this author Fred Saad More articles by this author Pierre Karakiewicz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...