BACKGROUND: Because of the lack of results from randomized clinical trials comparing the efficacy of aggressive therapies with that of more conservative therapies for clinically localized @entity263 , @entity1 and their physicians may select treatments based on other criteria. We examined the association of sociodemographic and clinical characteristics with four management options: radical prostatectomy, radiation therapy, hormonal therapy, and watchful waiting. METHODS: We studied 3073 @entity1 of the @entity263 Outcomes Study diagnosed from October 1, 1994, through October 31, 1995, with clinically localized disease (T1 or T2). @entity1 completed a baseline survey, and diagnostic and treatment information was abstracted from medical records. Multiple logistic regression analysis identified factors associated with initial treatment. All statistical tests were two-sided. RESULTS: @entity1 with clinically localized disease received the following treatments: radical prostatectomy (47.6%), radiation therapy (23.4%), hormonal therapy (10.5%), or watchful waiting (18.5%). @entity1 aged 75 years or older more often received conservative treatment (i.e., hormonal therapy alone or watchful waiting; 57.9% of @entity1 aged 75-79 years and 82.1% of @entity1 aged 80 years and older) than aggressive treatment (i.e., radical prostatectomy or radiation therapy) (for all age groups, P</=.001). After adjustment for age, clinical stage, baseline @entity1486 level, and histologic grade, the following factors were associated with conservative treatment: history of a @entity299 , being unmarried, geographic region, poor pretreatment bladder control, and @entity323 . In @entity1 younger than 60 years, use of aggressive treatment was similar by race/ethnicity (adjusted percentages = 85.5%, 88.1%, and 85.3% for white, African-American, and Hispanic @entity1 , respectively). However, among @entity1 60 years old and older, African-American @entity1 underwent aggressive treatment less often than did white @entity1 or Hispanic @entity1 (adjusted percentages for @entity1 aged 60-64 years = 67.1%, 84.7%, and 79.2%, respectively; 65-74 years = 64.8%, 73.4%, and 79.5%, respectively; and 75 years old and older = 25.2%, 45.7%, and 36.6%, respectively). CONCLUSIONS: The association of nonclinical factors with treatment suggests that, in the absence of definitive information regarding treatment effectiveness, @entity1 diagnosed with @entity263 should be better informed of the risks and benefits of all treatment options.

Factors associated with initial therapy for clinically localized XXXX : @entity263 outcomes study.

@entity1 :: ('9606', 'Species') :: ['participants', 'Patients', 'Participants', 'Men', 'men'] @entity323 :: ('MESH:D007172', 'Disease') :: ['impotence'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer', 'Prostate Cancer'] @entity299 :: ('MESH:D006331', 'Disease') :: ['heart attack'] @entity1486 :: ('354', 'Gene') :: ['prostate-specific antigen']
@entity263 :: (MESH:D011471,Disease) :: ['prostate cancer']
