title: Use of second treatment following definitive local therapy for prostate cancer: data from the caPSURE database.
abstract: OBJECTIVE
  We compare secondary cancer treatment use in patients who underwent definitive local treatment for prostate cancer.
  
  
  METHODS
  The rate of second cancer treatment was determined in patients who underwent radical prostatectomy (1,254), radiotherapy (499) or cryosurgery (141) using data from the CaPSURE database, a longitudinal disease registry of patients with prostate cancer. Second treatments started within 3 months after initial treatment were defined as adjuvant and those started more than 3 months were defined as nonadjuvant. Using a parametric regression model of survival analysis, second treatment rates were adjusted for differences in clinical and demographic characteristics, and duration of followup among groups.
  
  
  RESULTS
  Of the patients 4% received a second adjuvant treatment and 17% received a second nonadjuvant treatment within 3 years of initial therapy. Adjusted rates of nonadjuvant second treatment were lowest after radical prostatectomy, and 34 and 88% higher after radiation and cryosurgery, respectively (p = 0.01). This finding was most evident in patients with pretreatment prostate specific antigen 10.0 ng./ml. or less, clinical stage T2N0M0 disease, or Gleason score 6 or less on diagnostic biopsy, and in those classified as low risk for recurrence based on a combination of these parameters (p = 0.004).
  
  
  CONCLUSIONS
  Approximately 1 in 5 patients receive second cancer treatment within a mean of 3 years following initial local treatment for prostate cancer. Our data suggest that the likelihood of receiving second treatment was lowest in patients initially treated with radical prostatectomy.
authors.affiliation: Department of Urology and Mount Zion Cancer Center, University of California, San Francisco, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Grossfeld
authors.forename: D M
authors.initials: DM
authors.lastname: Stier
authors.forename: S C
authors.initials: SC
authors.lastname: Flanders
authors.forename: J M
authors.initials: JM
authors.lastname: Henning
authors.forename: W
authors.initials: W
authors.lastname: Schonfeld
authors.forename: K
authors.initials: K
authors.lastname: Warolin
authors.forename: P R
authors.initials: PR
authors.lastname: Carroll
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D003452:Cryosurgery; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D012042:Registries; D012044:Regression Analysis; D016019:Survival Analysis