title: 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.
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.
authors.affiliation: Department of Urology, Nara Medical University, Kashihara, Japan. sendo@naramed-u.ac.jp
authors.forename: Nobumichi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Akihide
authors.initials: A
authors.lastname: Hirayama
authors.forename: Shoji
authors.initials: S
authors.lastname: Samma
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Momose
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Masaki
authors.initials: M
authors.lastname: Haramoto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Otani
authors.forename: Shuji
authors.initials: S
authors.lastname: Watanabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Hirao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011468:Prostatectomy / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data*