{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:24:43Z","timestamp":1765355083025,"version":"3.41.2"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA138292"],"award-info":[{"award-number":["P30CA138292"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The 2012 United States Preventive Services Task Force (USPSTF) Grade D recommendation against prostate\u2010specific antigen (PSA) screening has resulted in a shift to higher\u2010stage prostate cancer (PC) at diagnosis. We evaluate the utilization of radical prostatectomy (RP) versus radiation therapy (RT) in the US for Gleason grade group 5 (GG5) prostate cancer before and after 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 34,011 men with localized GG5 PC undergoing primary therapy with (1) RP or (2) RT\u2009+\u2009androgen deprivation therapy (ADT) between 2004 and 2017 from the National Cancer Database. The chi\u2010square test was used to compare the relative use of RP and RT before versus after 2012. Annual use of RP versus RT from 2004 to 2017 was compared using Cochran\u2010Armitage test for trend. We modeled the effect of treatment year on the use of RP using multivariable logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Across all centers, the use of RP increased from 31% to 41% (<jats:italic>p<\/jats:italic> for trend &lt;\u20090.001). 2012 was associated with significant inflection for increase in RP use in all centers. There was an increased odds of receiving RP after 2012 (adjusted OR 1.34, 95% CI 1.28\u20131.40, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Utilization of RP for GG5 PC has significantly increased in the United States over the past decade. It remains unknown if outcomes may be compromised in this group of high\u2010risk men, many of whom require post\u2010prostatectomy RT and\/or ADT. Prospective comparison of RP versus RT\u2009+\u2009ADT for GG5 PC are needed to determine optimal treatment for these patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70624","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T17:39:58Z","timestamp":1738777198000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Utilization of Radical Prostatectomy Versus Radiation Therapy for Gleason Grade Group 5 Prostate Cancer Before and After <scp>USPSTF<\/scp> Grade D Recommendation Against Prostate\u2010Specific Antigen Screening in 2012"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3307-3703","authenticated-orcid":false,"given":"H. Scott","family":"McGinnis","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute, Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Corriher","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute, Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Janopaul\u2010Naylor","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute, Emory University  Atlanta Georgia USA"},{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subir","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute, Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute, Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zelin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics The University of Arizona  Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sagar A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute, Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Cancer Facts & 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