Suboptimal use of hormonal therapy among German men with localized high-risk prostate Cancer during 2005 to 2015: analysis of registry data

Background This study assesses the use of hormonal therapy to treat high-risk localized prostate cancer (HRLPCa) cases diagnosed between 2005 and 2015. Methods All N 0-X M 0 with ≥T 3a, or PCa cases with poorly differentiated feature (equivalent to Gleason score ≥ 8), diagnosed between 2005 and 2015...

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Published in:BMC cancer Vol. 22; no. 1; pp. 624 - 13
Main Authors: Abera, Semaw Ferede, Bedir, Ahmed, Glowka, André, Vordermark, Dirk, Medenwald, Daniel
Format: Journal Article
Language:English
Published: London BioMed Central 07.06.2022
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Androgen Antagonists - therapeutic use
Antineoplastic Agents, Hormonal - therapeutic use
Biomedical and Life Sciences
Biomedicine
Cancer registry
Cancer Research
Cancer therapies
Care and treatment
Chemotherapy
Health Promotion and Disease Prevention
High-risk
Hormonal therapy
Hormone therapy
Humans
Life expectancy
Male
Medicine/Public Health
Mortality
Neoplasm Grading
Oncology
Patients
Population
Prostate
Prostate cancer
Prostatic Neoplasms - drug therapy
Prostatic Neoplasms - radiotherapy
Radiation therapy
Registries
Research Article
S3-guideline
Statistics
Surgery
Surgical Oncology
Treatment
Germany
Treatment
Cancer registry
S3-guideline
Prostate cancer
High-risk
Germany
Hormonal therapy
ISSN:1471-2407, 1471-2407
Online Access:Get full text
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Summary:Background This study assesses the use of hormonal therapy to treat high-risk localized prostate cancer (HRLPCa) cases diagnosed between 2005 and 2015. Methods All N 0-X M 0 with ≥T 3a, or PCa cases with poorly differentiated feature (equivalent to Gleason score ≥ 8), diagnosed between 2005 and 2015 were extracted from German population-based cancer registries. Cases treated by surgery or chemotherapy were excluded. Description of hormonal therapy use by HRLPCa cases’ profile was presented. Relative risk (RR) was computed with a log-link function to identify factors associated with hormonal therapy use among radiotherapy-treated HRLPCa cases. Results A total of 5361 HRLPCa cases were analyzed. Only 27.6% (95% confidence interval [CI]: 26.4–28.8%) of the HRLPCa cases received hormonal therapy in combination with radiotherapy. The use of combined hormonal therapy and radiotherapy varied from 19.8% in Saxony to 47.8% in Schleswig-Holstein. Application of hormonal therapy was higher for the locally advanced cases compared to the poorly differentiated cases (relative risk [RR] = 1.28; 95%CI: 1.19, 1.37). Older patients showed a slightly increased use of hormonal therapy (RR for a 10-year age increase = 1.09; 95%CI: 1.02, 1.16). Compared to PCa cases from the most affluent residential areas, cases from the least affluent (RR = 0.71; 95%CI: 0.55, 0.92) and medium (RR = 0.75; 95%CI: 0.58, 0.96) areas had decreased use of hormonal therapy. The introduction of the German S3-guideline did not make a marked difference in the uptake of both hormonal therapy and radiotherapy (RR = 1.02; 95%CI: 0.95, 1.09). Conclusion This study found a low use of hormonal therapy among HRLPCa patients treated without surgery. The introduction of the German S3-guideline for prostate cancer treatment does not seem to have impacted hormonal therapy use.
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ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-022-09677-z