[2006] [1596] Choices for Definitive Treatment of Early-Stage Prostate Cancer: Results from the COMPARE Registry

David G. McLeod*, Washington, DC; Oliver Sartor, New Orleans, LA; Paul F. Schellhammer, Norfolk, VA; Anthony V. D'Amico, Boston, MA; Susan Halabi, Durham, NC; Peter T. Scardino,, Durham, NC.

Introduction and Objective:
Early stage prostate cancer is a disease with multiple treatment options. To ascertain initial definitive management strategies for prostate cancer in a broad-based group of practitioners representing all regions of the United States, data were analyzed from the Comprehensive Multicenter Prostate Adenocarcinoma Registry (COMPARE).
Methods:
COMPARE was initiated in October 2004 to evaluate management and outcomes of men with PSA recurrence following definitive treatment of organ confined prostate cancer. As of September 2005, enrollment has occurred at 146 physician sites: urologist (N=129), radiation oncologist (n=12), medical oncologist (n=3), miscellaneous (n=2). Most sites are private practice (n=132), with the remainder academic (n=14). The COMPARE database was examined to ascertain Gleason score, PSA, age, and choice of initial therapy (defined as therapy administered before PSA rise). Cryotherapy as an initial definitive therapy was an exclusion criteria.
Results:
Analysis of 678 men indicated initial treatment choices as follows: radical prostatectomy (RP) 302 (44.5%), external beam radiation therapy (EBRT) 208 (30.7%), brachytherapy (BT) 89 (13.1%), RP + EBRT 52 (7.7%), EBRT + BT 26 (3.8%), and miscellaneous 1 (0.1%). The BT group had a distinctly lower PSA (see Table) and higher percentage of men with a Gleason score of <7 on prostate needle biopsy (PNB) and thus would be expected to comprise a more favorable prognostic group. For men treated prior to recurrence with only one definitive therapy, the RP group had the highest percentage of men age <70 y (74.5%) and the EBRT group had the lowest (42.3%).
Conclusions:
The most common contemporary definitive treatment for local prostate cancer in the initial analysis of COMPARE was RP, followed by EBRT, and BT. Though distinctions in age, PSA, and Gleason scores between initial treatment subsets are noted, this cohort is reflective of current US practices and will provide valuable insights into the management and outcomes for men with rising PSA levels following local definitive therapies.
[table1]

Discussed Poster: Prostate Cancer: Localized (III) (1:00 PM-4:00 PM)