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Open Access Research article

The primary therapy chosen for patients with localized prostate cancer between the university hospital and its affiliated hospitals in Nara Uro-oncological research group registration

Nobumichi Tanaka1*, Kiyohide Fujimoto1, Akihide Hirayama1, Shoji Samma2, Hitoshi Momose2, Yoshiteru Kaneko2, Masaki Haramoto2, Yoshiki Hayashi2, Yoshinori Nakagawa2, Takeshi Otani2, Shuji Watanabe2 and Yoshihiko Hirao1

Author Affiliations

1 Department of Urology, Nara Medical University, Kashihara, Japan

2 Nara Uro-Oncological Research Group, Kashihara, Japan

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BMC Urology 2011, 11:6  doi:10.1186/1471-2490-11-6

Published: 27 April 2011

Abstract

Background

We investigated the differences between the preferential primary therapy conceived by the primary doctors and the primary therapy actually conducted for prostate cancer patients in Nara, Japan.

Methods

The distribution of primary therapy and clinical characteristics of 2303 prostate cancer patients - diagnosed between 2004 and 2006 at Nara Medical University and its 23 affiliated hospitals - were assessed. Moreover, the preferential primary therapy for the patients at each clinical stage (cT1-T3bN0M0) conceived by the primary doctors was investigated and compared to the actual therapy.

Results

Of all patients, 51% received primary androgen deprivation therapy (PADT), 30% underwent radical prostatectomy (RP), and 14% received radiation therapy (RT). The preferential primary therapy for cT1-2N0M0 was RP (92%) while 38% of the patients actually received PADT (RP: 40%). For cT3aN0M0, the preferential primary therapy was both RP and external beam radiation therapy (EBRT) while 58% of the patients actually received PADT (RP: 16%, EBRT: 24%). For cT3bN0M0, the most preferential primary therapy was EBRT (46%) while 67% of the patients actually received PADT (EBRT: 21%). This trend was more notable in the affiliated hospitals than in the University hospital. The hospitals with lower volume of RP per year significantly conducted PADT compared with those with higher volume of RP.

Conclusions

PADT was commonly used to treat localized prostate cancer as well as locally advanced prostate cancer in Japan. There was a definite discrepancy between the preferential primary therapy conceived by the primary doctors and the actual therapy provided to the patients.