Management of prostate cancer in China: a multicenter report of 6 institutions.
OBJECTIVE
In China the incidence of prostate cancer (PCa) is low and sparse data are available regarding its management. We analyzed the management of PCa at 6 Chinese urological institutions.


METHODS
A retrospective analysis was performed of 431 consecutive patients treated for PCa at 6 Chinese institutions, including 5 in the divisions of Shanghai and 1 in the province of Chongqing, between January 2000 and December 2004. Tumor characteristics, therapeutic options and patient outcomes were recorded.


RESULTS
At diagnosis median patient age was 72 years and median prostate specific antigen was 46.1 ng/ml. Most PCa cases were revealed by urinary symptoms (75.9%) or bone pain (12.8%). PCa was palpable on digital rectal examination in 74% of cases. At least 44 patients (10.2%) had metastases to lymph nodes at diagnosis and 112 (26%) had bone metastases. A total of 236 patients underwent bilateral orchiectomy and 100 received medical hormone therapy, which in 75% consisted of antiandrogen alone. At a median followup of 16.8 months 60% of these patients experienced biological recurrence. Radical prostatectomy was performed in 24 patients as monotherapy or in combination with bilateral orchiectomy. No patient with clinically localized PCa experienced biological recurrence after radical prostatectomy.


CONCLUSIONS
The management of PCa in China differs from that in Western countries. To date surgical castration represents standard treatment. Screening detection of PCa could help detect earlier stage tumors and improve the outcome in patients.
Peyromaure
Michaël
M
Department of Urology, Cochin Hospital, Paris, France. michael.peyromaure@cch.ap-hop-paris.fr
Debré
Bernard
B
Mao
Kaili
K
Zhang
Guoqiang
G
Wang
Yiran
Y
Sun
Zhongquan
Z
Xu
Danfeng
D
Jiang
Jun
J
Sun
Yinghao
Y
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D002681:China / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D009919:Orchiectomy / Q000379:methods; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen