Regional and facility disparities in androgen deprivation therapy for prostate cancer from a multi-institutional Japan-wide database

Int J Urol. 2021 May;28(5):584-591. doi: 10.1111/iju.14518. Epub 2021 Feb 24.

Abstract

Objectives: To examine the differences in prognosis of prostate cancer patients receiving primary androgen deprivation therapy by region and facility type using a Japan-wide database.

Methods: Data on patients treated with primary androgen deprivation therapy between 2001 and 2003 from a nationwide community-based database established by the Japan Study Group of Prostate Cancer were obtained. Clinicopathological characteristics and prognostic variables, including progression, cancer-specific survival and overall survival, were compared according to region and facility type where the patients were treated.

Results: Among 19 162 patients, 7102 (37.1%) and 12 060 (62.9%) men were in urban and rural areas, respectively, and 3556 (18.6%), 13 623 (71.1%) and 1983 (10.3%) patients were enrolled from academic centers, non-academic hospitals and urological clinics, respectively. The risks of progression, cancer-specific mortality and all-cause mortality were comparable between urban and rural areas in propensity-score matched analysis. Risks of progression, cancer-specific mortality and all-cause mortality in urological clinics were higher than those in academic centers in propensity-score matched analysis.

Conclusions: Our findings suggest that Japan facility type, but not geographical regions, might affect the prognosis of prostate cancer patients receiving primary androgen deprivation therapy.

Keywords: androgen deprivation therapy; facility; prostate cancer; rural area; urban area.

MeSH terms

  • Androgen Antagonists* / therapeutic use
  • Androgens
  • Humans
  • Japan / epidemiology
  • Male
  • Prognosis
  • Prostatic Neoplasms* / drug therapy

Substances

  • Androgen Antagonists
  • Androgens