title: Radical prostatectomy: pathology findings in 1001 cases compared with other major series and over time.
abstract: OBJECTIVE
  To examine the preoperative features and pathological outcomes of clinical significance of 1001 consecutive essentially unscreened men who had a radical prostatectomy (RP) in the UK between 1988 and 2002, and their changes over time.
  
  
  METHODS
  The details of men whose RP specimen was submitted for analysis were entered into the RP database held at the University College Hospital, London; the National Health Service and private patients of 17 surgeons were included. The age, mode of diagnosis, preoperative prostate specific antigen (PSA) level, biopsy and RP findings were compared over time.
  
  
  RESULTS
  The mean (range) age of the men was 62 (40-76) years, the median PSA 8 (0.1-146) ng/mL and the median biopsy Gleason sum score 6; these preoperative features did not change over the study period. The diagnosis of prostate cancer was made by transurethral resection of the prostate alone in 48 men (5%). The maximum number of patients receiving neoadjuvant androgen ablation was 21 (33%) in 1996, and subsequently declined. The median (range) RP Gleason sum score was 7 (4-9). The biopsy Gleason score correlated with the prostatectomy Gleason score in 252 (47%) of 536 men, being lower in 170 (32%) and higher in 113 (21%). The median tumour volume was 2 mL (focus of invasive acini - 31 mL) and the incidence of positive intra- and extraprostatic margins was 52%. Both tumour volume and extraprostatic margin positivity declined with time.
  
  
  CONCLUSIONS
  The preoperative features and pathological findings from this UK series are similar to those of other reported cohorts from unscreened populations. The incidence of positive extraprostatic surgical margins, tumour volume and stage decreased with time.
authors.affiliation: Institute of Urology, University College London, London, UK. simonrjbott@hotmail.com
authors.forename: Simon R J
authors.initials: SR
authors.lastname: Bott
authors.forename: A Alex
authors.initials: AA
authors.lastname: Freeman
authors.forename: Sally
authors.initials: S
authors.lastname: Stenning
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cohen
authors.forename: M Constance
authors.initials: MC
authors.lastname: Parkinson
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001706:Biopsy / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000706:statistics & numerical data*
chemical_list: D017430:Prostate-Specific Antigen