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PURPOSE Intensity-modulated radiation therapy (IMRT) and laparoscopic or robotic minimally invasive radical prostatectomy (MIRP) are costlier alternatives to three-dimensional conformal radiation therapy (3D-CRT) and open radical prostatectomy for treating prostate cancer. We assessed temporal trends in their utilization and their impact on national health(More)
BACKGROUND Although the use of minimally invasive radical prostatectomy (MIRP) has increased, there are few comprehensive population-based studies assessing temporal trends and outcomes relative to retropubic radical prostatectomy (RRP). OBJECTIVE Assess temporal trends in the utilization and outcomes of MIRP and RRP among US Medicare beneficiaries from(More)
OBJECTIVES Salvage radical prostatectomy (RP) is performed with curative intent following post-radiotherapy recurrence for prostate cancer. While single-center salvage RP outcomes appear promising, little is known about outcomes in the community setting in elderly men. We sought to evaluate utilization, outcomes, and costs of salvage RP vs. primary RP in(More)
OBJECTIVE To evaluate the use and outcomes of adjuvant radiation therapy (ART) for men with lymph node (LN)-positive disease after radical prostatectomy (RP) using a population-based approach. PATIENTS AND METHODS Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data from 1995 to 2007 was used to identify 577 men with LN metastases(More)
STUDY TYPE Prognosis (cohort). LEVEL OF EVIDENCE 2b. What's known on the subject? and What does the study add? Prior population and single-centre studies have assessed incidence of positive surgical margins. The current study derived population-based positive surgical margin cut-offs in order to help identify underperforming surgeons who may benefit from(More)
BACKGROUND Evidence-based consensus guidelines recommend only observation for men with low-risk prostate cancer and life expectancy less than 10 years. This report describes the incidence, drivers, cost, and morbidity of overtreatment of low-risk prostate cancer within the United States. METHODS The SEER-Medicare Program was used to identify 11,744 men(More)
161 Background: The National Comprehensive Cancer Network (NCCN) recommends active surveillance as the sole option for men with low-risk prostate cancer (LRPC) and a life expectancy <10 years. We sought to describe the incidence, risk factors, cost, and morbidity related to overtreatment of LRPC within the United States. METHODS We used the Surveillance,(More)
BACKGROUND With advances in oncologic treatment, cosmesis after mastectomy has assumed a pivotal role in patient and provider decision making. Multiple studies have confirmed the safety of both chemotherapy before breast surgery and immediate reconstruction. Little has been written about the effect of neoadjuvant chemotherapy on decisions about(More)
PURPOSE While perineal radical prostatectomy has been largely supplanted by retropubic and minimally invasive radical prostatectomy, it was the predominant surgical approach for prostate cancer for many years. In our population based study we compared the use and outcomes of perineal radical prostatectomy vs retropubic and minimally invasive radical(More)
PURPOSE Routine imaging for staging low risk prostate cancer is not recommended according to current guidelines. We characterized patterns of care and factors associated with imaging overuse. MATERIALS AND METHODS We used SEER-Medicare linked data to identify men diagnosed with low risk prostate cancer from 2004 to 2005, and determined if imaging(More)