title: Shift of tumor features in patients with clinically localized prostate cancer undergoing radical prostatectomy since the beginning of the PSA era.
abstract: 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.
authors.affiliation: Department of Urology, Medical University of Graz, Graz, Austria. herbert.augustin@meduni-graz.at
authors.forename: Herbert
authors.initials: H
authors.lastname: Augustin
authors.forename: Marco
authors.initials: M
authors.lastname: Auprich
authors.forename: Philipp
authors.initials: P
authors.lastname: Stummvoll
authors.forename: Katja
authors.initials: K
authors.lastname: Lipsky
authors.forename: Karl
authors.initials: K
authors.lastname: Pummer
authors.forename: Peter
authors.initials: P
authors.lastname: Petritsch
mesh_terms: 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
chemical_list: D017430:Prostate-Specific Antigen