Shift of tumor features in patients with clinically localized prostate cancer undergoing radical prostatectomy since the beginning of the PSA era.
OBJECTIVE
To analyze trends of clinical and tumor characteristics over a 12-year period since the beginning of the prostate-specific antigen (PSA) era in a consecutive series of radical prostatectomies.


METHODS
Between 1993 and 2004 a consecutive series of 1351 patients underwent radical prostatectomy for clinically localized prostate cancer (PC) in a single institution. Clinical and histopathological information was entered into our computer database and analyzed for changes over time.


RESULTS
The annual frequency of surgical interventions increased from 43 to 160 (272%) during the observation period (r = 0.930; p < 0.01). The detection of PC based solely on pathological PSA levels rose impressively from 7% to 70% (r = 0.986; p < 0.01). The rates of organ-confined disease also increased significantly from 47% to 79% (r = 0.774; p < 0.01). Stage pT3a decreased somewhat from 28% to 18% (r = -0.389; n.s.) whereas pT3b decreased significantly from 26% to 3% (r = -0.729; p < 0.01).


CONCLUSIONS
During the 12-year period, PC was increasingly detected on the basis of a pathological PSA level only and shifted significantly to more organ-confined stages. With a time delay, these findings are consistent with trends observed in large centers in the USA.
Augustin
Herbert
H
Department of Urology, Medical University of Graz, Graz, Austria. herbert.augustin@meduni-graz.at
Auprich
Marco
M
Stummvoll
Philipp
P
Lipsky
Katja
K
Pummer
Karl
K
Petritsch
Peter
P
D001317:Austria / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000639:trends*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000706:statistics & numerical data* / Q000639:trends; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen