While the benefits of androgen ablation therapy have been well documented in patients with locally advanced and metastatic prostate cancer, there is a paucity of evidence its role in patients with low-grade, low-stage disease.
In the June 21st issue of JNCI, Shahinian and colleagues from the University of Texas in Galveston report on an analysis from SEER data evaluating the driving factors for choosing hormone ablation. Using a SEER-Medicare linked database, the authors identified 61,717 men diagnosed with prostate cancer between 1992 and 1999. A total of 1802 urologists were identified to assess the importance of physician preference as the catalyst for starting androgen ablation within 6 months of diagnosis.
Multivariate analysis was performed to quantify the variation in androgen ablation use between patient characteristics, tumor characteristics (grade or stage), and urologist preference. The patient characteristics evaluated included age, ethnicity, socioeconomic status, co morbid illnesses, year of diagnosis, and state of residence. One-third of patients had received androgen ablation within 6 months of diagnosis.
Interestingly, the percentage of the total variance in the use of hormone ablation attributed to the urologist (23%) was significantly higher that what could be assigned to tumor (9.7%) or patient characteristics (4.3%).