INTRODUCTION AND OBJECTIVE: National Comprehensive Cancer Network (NCCN) guideline-based treatment provides a benchmark of quality patient care. The impact of compliance with guidelines on the treatment of prostate cancer patients is yet to be defined.METHODS: We retrospectively reviewed our prospectively maintained Prostate Cancer Database. All patients were presented to the biweekly Localized Prostate Cancer Conference (LPCC) that includes urologists, radiation oncologists, genitourinary pathologists and patient advocates. All patients received a formal letter with the consensus recommendation. Patients treated in community-based practices were called to determine the treatment received. Data were analyzed for concordance among the LPCC recommendations, community recommendations, and treatment received. Chi square tests assessed equality of proportions, with correction for continuity. Multivariate logistic regression analysis was used to illicit predictors of concordance between LPCC and treatment received.RESULTS: 1560 patients were analyzed. Mean age was 61AE7 years. Patients were classified according to NCCN risk as low (7%), intermediate (69%), or high (25%). LPCC's recommendations matched treatment received in 90%, while community-based recommendations matched treatment received in 64% (Figure). Concordance was more common in the more recently (2010)(2011)(2012)(2013)(2014)(2015) compared to earlier (2005)(2006)(2007)(2008)(2009)(2010).CONCLUSIONS: NCCN-based recommendations were more concordant with patient's treatment decisions compared to communitybased recommendations, especially among patients with higher disease stage and more recently. To our knowledge, this is the first study that compared NCCN and community-based recommendations and their impact on decision making.