Prostate

—Miller DC, Spencer BA, Shah, RB, Ritchey J, Stewart AK, Gay EG, Dunn RL, Wei JT, Litwin MS.  The Quality of Surgical Pathology Care for Men Treated with Radical Prostatectomy in the United States.  Cancer [e-pub 9 may 2007 in Wiley InterScience (www.interscience.wiley.com]

—Miller DC, Spencer BA, Ritchey J, Stewart AK, Dunn RL, Sandler HM, Wei JT, Litwin MS.  Treatment Choice and Quality of Care for Men with Localized Prostate Cancer.  Medical Care May 2007, 45:5.

—Miller DC, Hafez KS, Stewart AK, Montie JE, Wei JT.  Prostate Carcinoma Presentation, Diagnosis, and Staging.  Cancer 2003; 98:1169-1178.

—Mettlin CJ, Murphy GP, McDonald CJ, Menck HR. The National Cancer Data Base report on increased use of brachytherapy for the treatment of patients with prostate carcinoma in the U.S. Cancer 1999; 86:1877-1882. (!)

—Mettlin CJ, Murphy GP. The National Cancer Data Base report on prostate cancer following the peak in incidence rates in the United States. Cancer 1998; 83:1679-1684. (!)

—Guinan P, Stewart AK, Fremgen AM, Menck HR. Patterns of care for metastatic carcinoma of the prostate gland: Results of the American College of Surgeons' patient care evaluation study. Prostate Cancer and Prostatic Diseases 1998; 1:315-320. (!)

—Mettlin CJ, Murphy GP Cunningham MP, Menck HR. The national cancer data base report on race, age and region variations in prostate cancer treatment. Cancer 1997; 80:1261-6. (!)

—Mettlin CJ, Murphy GP, Sylvester J, McKee RF, Morrow M, Winchester DP. Rusults of hospital cancer registry surveys by the american college of surgeons: Outcomes of prostate cancer treatement by radical prostatectomy. Cancer 1997; 80:1875-81. (!)

—Mettlin C. Changes in patterns of prostate cancer care in the united states: results of american college of surgeons commission on cancer studies, 1974-1993. Prostate 1997; 32:221-6. (!)

—Mettlin CJ, Murphy GP, Ho R, Menck HR. The National Cancer Data Base report on longitudinal observations on prostate cancer. Cancer 1996; 77:2162-2166.

NCDB data were collected following a computerized, standard format. Hospital participation was voluntary. Since the first year of data collection, the number of participating hospitals increased from 496 to 996 and the number of prostate cancer patients reported to the NCDB increased from 19,531 to 84,408. The proportion of men diagnosed at ages younger than 70 years increased from 37.8% in 1986 to 46.9% in 1993. Completeness of reporting stage of disease and tumor grade improved. The proportions of both the earliest (American Joint Committee on Cancer [AJCC] stage groups 0 and I) and the most advanced (AJCC stage Group IV) stages declined. The proportion of grade 2 (moderately differentiated) tumors increased from 38.6% in 1986 to 57.5% in 1993. The proportion of AJCC stage II prostate cancer increased from 19% in 1986 to 48.4% in 1993. The proportion of patients treated by prostatectomy increased from 9.9% in 1986 to 29.2% in 1993. The proportion of patients receiving no cancer directed treatment declined from 41.8% in 1986 to 21.6% in 1993. Less change was observed in the use of radiation and hormonal treatments.

—Jones GW, Mettlin CJ, Murphy GP, Guinan P, Herr HW, Hussey DH, Chmiel JS, Fremgen AM, Clive RE, Zuber-Ocwieja KE, Winchester DP. Patterns of care for carcinoma of the prostate gland: Results of a national survey of 1984 and 1990. J Am Coll Surg 1995; 180:545-554. (*) (!)

Data were received from 730 hospitals on 14,716 patients with newly diagnosed adenocarcinomas of the prostate gland in 1984 and from 1,035 hospitals for 23,214 patients with carcinoma of the prostate gland in 1990. From 1984 to 1990, there was increased diagnostic use of the prostate specific antigen (PSA) test (from 5.1% to 66.4% of incident carcinomas) and transrectal ultrasound (TRUS) (0.9% to 19.7%). Use of the prostatic acid phosphatase assay declined from 62.4% to 47 %. Although the proportion of early stage (0, I, II) disease increased for all racial or ethnic groups combined, the greatest increase was for whites (from 57.3% to 60.6%). The increase was smaller for African-Americans (from 46.9% to 48.3%). The use of radical prostatectomy without radiation therapy or chemotherapy significantly increased from 7.3% to 20.3%, while the proportion of patients receiving no carcinoma-directed treatment decreased. Radiation therapy remained the same. Hormone therapy without radical prostatectomy declined. African-Americans had a lower 5-year survival rate than whites, even when stratified for stage.

—Mettlin CJ, Murphy GP, McGinnis LS. Prostate cancer. In: Steele GD, Jessup JM Winchester DP, Menck HR, Murphy GP: eds. National Cancer Data Base: Annual review of patient care, 1995. Atlanta, GA: American Cancer Society, 1995; 38-47 (!)

Data were received on 52,597 prostate cancer cases from 1986-1987 and 101,903 cases from 1992. These data represent approximately 30% and 77% of all prostate cancers diagnosed in the United States in 1986-1987 and 1992, respectively. Tables include percent of cases, stage, treatment, and relative survival by selected patient, tumor, and reporting hospital characteristics.

—Mettlin CJ, Murphy GP, McGinnis LS, Menck HR. The National Cancer Data Base report on prostate cancer. Cancer 1995; 76:1104-1112.

Calls for Data yielded a total of 52,597 prostate cancer reports for 1986-1987 and 101,903 for 1992 from hospital cancer registries across the United States. Data were received for 154,500 patients with prostate cancer. Prostate cancer is detected increasingly at localized stages and among younger men. African-American men have a continuing pattern of more advanced disease at diagnosis. Selection of prostatectomy as the primary treatment has increased, and its use varies by region and several patient and hospital characteristics. Selection of radiation treatment has increased to a lesser degree. The 5-year survival for patients diagnosed in 1986-1987 was 60%. Outcomes varied by stage, age, and race.

—Mettlin CJ, Murphy GP. The National Cancer Data Base report on prostate cancer. Cancer 1994; 74:1640-1648.

Two Calls for Data provided a total of 85,813 prostate cancer reports from hospital registries across the country. The proportion of the early stage, curable prostate cancers diagnosed in the United States has increased. In 1990, African-American patients were more likely to be diagnosed with metastatic prostate cancer than were non-Hispanic whites. The proportion of patients treated by prostatectomy increased between 1974 and 1990. Consistent with the pattern of more advanced disease at diagnosis, African-American patients were less likely to have received prostatectomy or radiation treatment and more likely to have received only hormonal treatment. Prostate cancer survival was strongly associated with disease stage. African-American men had a lower 5-year survival than did non-Hispanic white men.

—Mettlin CJ, Murphy GP: Prostate cancer. In: Steele GD, Winchester DP, Osteen RT, Menck HR, Murphy GP: eds. National Cancer Data Base: Annual review of patient care, 1994. Atlanta, GA: American Cancer Society, 1994.

Data on 17,139 prostate cancer cases were received from 464 hospitals in 1985, 20,185 cases from 474 hospitals in 1986, and 67,797 cases from 937 hospitals in 1991. These data represent approximately 21%, 22%, and 56% of all prostate cancers in the United States in 1985, 1986, and 1991, respectively. These data begin to show the impact of the growing use of the PSA test in the early detection of prostate cancer. The changes from 1985/1986 to 1991 seen in these data reflect only the beginning of increased detection of early-stage prostate cancer in men at risk of getting the disease. Continued monitoring of NCDB prostate cancer data will be valuable for evaluating the impact of improved early detection on patient survival and to assess the rapidity of diffusion of new patient management standards throughout the U.S. The advances in early detection are not impacting equally on all segments of the population at risk. The differences in the proportion of advanced cancers diagnosed in African-American and white men are large. Further research is needed to determine the reasons for the adverse pattern of diagnosis in African-American men, and institutions need to be aware of the high-risk populations in early-stage prostate cancer since detection efforts at the community level may benefit these population segments.

—Mettlin CJ, Murphy GP, Menck HR. Trends in treatment of localized prostate cancer by radical prostatectomy: Observations from the Commission on Cancer National Cancer Data Base 1985-1990. Urology 1994; 43:488-492.

NCDB prostate cancer data on 4,531 patients treated in 1985, 25,028 treated in 1988, and 21,697 treated in 1990 were reviewed. The data indicated that selection of radical prostatectomy increased markedly over this interval. Use of radical prostatectomy was greatest in younger men in every year studied. The proportion of patients treated by radical prostatectomy was greatest in the western United States and least in New England and the Mid-Atlantic region. Radical prostatectomy was associated with the patient's socioeconomic status and race as well as with the hospital's caseload of patients with cancer. The pattern of care for localized prostate cancer is changing significantly. Further research is needed to assess whether these variations reflect differences in access to care or patterns of patient preference.

—Murphy GP, Mettlin CJ, Menck HR, Winchester DP, Davidson AM. National patterns of prostate cancer treatment by radical prostatectomy: Results of a survey by the American College of Surgeons' Commission on Cancer. J Urol 1994; 152:1817-1819. (*)

To evaluate the patterns of use of radical prostatectomy for the treatment of prostate cancer in the United States, the American College of Surgeons Commission on Cancer in association with the American Cancer Society and American Urological Association surveyed 484 institutions concerning 2,122 patients treated in 1990. The results revealed that 93% of the patients were younger than 75 years when treated. Pretreatment PSA level was greater than 4.0 ng/ml in 85.4% of the patients. Surgical- pathological evaluation showed that 57.5% of the patients treated had American Urological Association stages A1 to B2. Positive pathological findings, for example microscopic tumor extension or invasion, were associated with elevated PSA levels at follow up. The mortality rate associated with the operation was 0.7%. Impotence following treatment was observed in 56.6% of the patients who were potent preoperatively and complete incontinence was reported in 3.6% of the patients who were previously continent. The data may provide benchmarks by which further trends in prostate cancer treatment may be compared.

—Mettlin CJ, Murphy GP: Prostate cancer. In: Steele GD, Winchester DP, Menck HR, Murphy GP: eds. National Cancer Data Base: Annual review of patient care, 1993. Atlanta, GA: American Cancer Society, 1993; 37-51.

Two Calls for Data yielded a total of 85,713 prostate cancer cases: 16,290 cases for 1985 from 486 hospitals; 24,849 cases for 1988 from 597 hospitals; and 44,674 cases for 1990 from 837 hospitals. These data represent approximately 18% of all U.S. prostate cancer cases for 1985, 25% for 1988, 42% for 1990. Data include age at diagnosis by ethnicity and region, trends and variation in disease at diagnosis by ethnicity, region, and hospital size, AJCC stage, treatment over time, treatment by stage, ethnicity, region, and type of hospital, trends and variations in survival by stage and ethnicity.

—Mettlin CJ, Jones GW, Murphy GP. Trends in prostate cancer care in the United States, 1974-1990: Observations from the patient care evaluation studies of the American College of Surgeons Commission on Cancer. CA 1993; 43:83-91. (*)

—Natarajan N, Murphy GP, Mettlin CJ. Prostate cancer in blacks: An update from the American College of Surgeons patterns of care studies. J Surg Oncol 1989; 40:232-236. (*)

—Schmidt J, Mettlin CJ, Natarajan N, Peace BB, Beart RW, Winchester DP, Murphy GP. Trends in patterns of care for prostate cancer, 1974-1983: Results of surveys by the American College of Surgeons. J Urol 1986; 136:416-421. (*)

Data from a survey of patterns of care for prostate cancer sponsored by the American College of Surgeons suggested several trends when compared to similar data from a decade ago. The observed differences include an increased diagnosis of localized cancer and an increased use of acid phosphatase determinations, bone scans, radical retropubic prostatectomy, radiotherapy (particularly interstitial techniques) and orchiectomy. In contrast, the use of bone surveys, perineal prostatectomy, and hormonal therapy decreased. Transurethral resection continued to be the most common means to establish the diagnosis of prostate cance,r but the data suggested that the tumors were being staged and graded in more patients. Five-year survival rates appeared to be improving for all stages and for white and black patients. Survival of black patients continues to lag behind that of white subjects, presumably owing to the more advanced stage of disease at diagnosis observed in these data. These findings may have important implications for understanding trends in survival of patients with this disease.

—Huben R, Natarajan N, Pontes JE, Mettlin CJ, Smart CR, Murphy GP. Carcinoma of the prostate in men less than 50 years old: Data from national survey by the American College of Surgeons. Urology 1983; 20:585-588. (*)

—Mettlin CJ, Natarajan N. Epidemiologic observations from the American College of Surgeons' survey of prostate cancer. The Prostate 1983; 4:323-331. (*)

—Murphy GP, Mettlin CJ, Natarajan N. The problem of prostate cancer among blacks in the United States. Proc American Cancer Society Caribbean and Central AmericanCancer Conference, Bal Harbor, Florida, May 22-24, 1983. (*)

—Natarajan N, Mettlin CJ, Murphy GP. Patterns-of-Care surveys of the AmericanCollege of Surgeons' Commission on Cancer. In: Mettlin CJ, Murphy GP, eds. Progress in Cancer Control III: A Regional Approach. New York, Alan R. Liss, Inc., 1983; 187-199. (*)

—Mettlin CJ, Natarajan N, Murphy GP. Recent patterns of care of prostate cancer patients in the United States: Results from the surveys of the American College of Surgeons' Commission on Cancer. In: Murphy GP, ed. International Advances in Surgical Oncology. Vol. V, New York, Alan R. Liss, Inc., 1982; 227-321. (*)

—Murphy GP, Natarajan N, Pontes JE, Schmitz RL, Smart CR, Schmidt JD, Mettlin CJ. The national survey of prostate cancer in the United States by the American College of Surgeons. J Urol 1982; 127:928-934. (*)

Data from the 1980 long- and short-term surveys of the American College of Surgeons Commission on Cancer were examined to identify recent trends in the management of prostate cancer. The clinical stage distribution of patients demonstrates that higher proportions of patients were diagnosed as having occult or incidental and advanced stage D disease in the 1979 study as opposed to the 1974 series. In both periods, black patients were diagnosed less often with localized stage cancer and were observed more often to have advanced diseases. Transurethral resection and rectal examination were reported as the most common means of diagnosing prostate cancer. In both series alkaline and serum acid phosphatase studies were performed on the majority of patients, although the use was greater in the 1979 series. The use of bone scans increased nearly 3-fold from 1974 to 1979. In the long-term survey (1974 and earlier), hormone therapy was the treatment used most often, either alone or in combination with surgery or radiation. Obviously, this treatment was used in many patients with metastatic disease. In the short-term survey (1979 and earlier), a larger proportion was observed to receive hormonal therapy. The use of radiation therapy appeared to have increased, particularly for stages B and C disease in the 1979 series. At 5 years from initial diagnosis 77.7% of patients with clinical stage A disease survived compared to 23% with clinical stage D cancer. Throughout the study, African-American patients had a poorer survival rate than white patients.

—Murphy GP. Prostate Cancer: Continuing Progress. Cancer 1981; 31:96-110. (*)

—Murphy GP: Prostate Cancer Today. Urology (Supplement)1981; 27:1-3. (*)

—Murphy GP, Schmitz RL. Prostate cancer: An evaluation of patient management. Bulletin of the American College of Surgeons 1981; 66:17-19. (*)

A 1974 survey of 20,166 prostate cancer patients and a 1979 survey of 14,079 patients showed a higher number of patients in both the localized and the advanced stages of the disease in 1979. Both studies showed that black patients were more often clinically diagnosed as having an advanced stage, rather than a localized stage of the disease. Transurethral resection (TUR) and rectal examination were the more common means of diagnosing prostate cancer. Alkaline and serum acid phosphatase studies were used more often in 1979. Bone scans increased nearly threefold between the two studies, and a larger proportion of patients in the 1979 study underwent transurethral resection only. In each stage of the disease, a smaller proportion of 1979 study patients received hormonal therapy. Radiation treatment also increased in the 1979 group, particularly among patients with disease stages B and C. Five-year survival rates for the 1974 patients ranged from 77.7% for stage A patients to 23% for stage D. The study also indicated a lower survival rate for black patients as compared to white.

 

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