The Relationship Between Clinical Benefit and Receipt of Curative Therapy for Prostate Cancer

Abstract

Life expectancy (LE) and tumor characteristics are clinical factors that affect the likelihood of benefit from curative therapy (CTx) for prostate cancer. Treatment of patients with a shorter LE may contribute to additional costs or complications, without a commensurate improvement in quality of life or survival.^1-3 The National Comprehensive Cancer Network practice guidelines in oncology⁴ recommend active surveillance as an alternative to CTx (radical prostatectomy or radiation therapy) for patients with low-risk tumor characteristics who have an LE of less than 10 years. For patients with intermediate-risk cancers and an LE of 10 years or more, CTx is recommended.⁴ Although therapeutic options for patients with prostate cancer have expanded considerably in recent years, little is known about whether the treatment of men with early-stage prostate cancer has evolved.^5-7 It is unclear whether patterns of care correspond to the likelihood of clinical benefit from treatment, as determined by LE and tumor characteristics. We therefore assessed trends in the use of CTx across strata of potential clinical benefit.