Inverse stage migration in patients undergoing radical prostatectomy: results of 8916 European patients treated within the last decade

• DOI: 10.1111/j.1464-410x.2010.09982.x
• Publication Date: 2011-01-18T13:45:09Z
• Authors: Lars Budäus; Jan Spethmann; Hendrik Isbarn; Jan Schmitges; Laura Beesch; Alexander Haese; Georg Salomon; Thorsten Schlomm; Margit Fisch; Hans Heinzer; Hartwig Huland; Markus Graefen; Thomas Steuber
• Keywords: Adult; Male; Prostatectomy; Prostate; Prostatic Neoplasms; Middle Aged; Prostate-Specific Antigen; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Germany; Humans; Prospective Studies; Aged; Neoplasm Staging

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does study add? The widespread use PSA testing resulted in a stage migration towards clinical organ‐confined prostate cancers at diagnosis during last decade. However, our large cohort demonstrates an increasing proportion patients with non‐organ confined after radical prostatectomy. These findings may be related to introduction new, non‐established treatment options for low‐risk cancer years growing adoption RP multimodal setting locally advanced tumours. OBJECTIVE • To investigate patterns decade European men treated prostatectomy (RP). PATIENTS AND METHODS Between 2000 2009, was performed 8916 single tertiary‐care institution. Age diagnosis, pathological data were prospectively collected, trends proportions preoperative analysed over time. RESULTS median (mean) age increased from 62 (62) 63 (65) between 2009 ( P < 0.001). When stratified based their according D’Amico risk groups disease progression, dropped 66% 2004 35% = 0.016) final year period. Similarly, histopathological evaluation specimens showed decrease favourable (organ confinement Gleason 3 + grade) 53 17% 0.008). This trend accompanied by increase number non‐organ‐confined (PCa) 19% 2003 33% restriction analyses present centre could limit generalizeability results. CONCLUSIONS During decade, we observed inverse those PCa who RP. recorded changes patient selection settings tumours as well availability new alternatives disease.