title: Changes in prostate cancer at radical prostatectomy during the prostate specific antigen era: an Italian experience.
abstract: OBJECTIVE
  To assess changes in prostate cancer clinical and pathologic features by review of 15 years' experience with radical prostatectomy.
  
  
  METHODS
  A total of 596 consecutive patients who underwent open or laparoscopic radical prostatectomy (RP) between 1991 and 2006 were included. All had clinically localized prostate cancer. Surgical specimens were analyzed or blindly reviewed by a uropathologist, and whole-mount sections were prepared. Statistical analysis evaluated whether significant changes in clinical and pathologic variables occurred over time.
  
  
  RESULTS
  Median prostate specific antigen (PSA) values at diagnosis significantly decreased over time. Definite stage migration was observed, with significant increase of organ-confined tumors. Incidence of seminal vesicle and lymph node involvement declined steadily. Median tumor volume decreased significantly over time (p<0.001). Incidence of nonsignificant cancers at RP increased significantly, reaching 25.6% in 2006. PSA value has progressively lost correlation with prostate cancer volume and today correlates only with prostate gland volume.
  
  
  CONCLUSIONS
  Prostate cancer stage and volume at diagnosis have steadily decreased in the last 15 years, likely reflecting increasing use of PSA testing. In early prostate cancer, PSA level no longer correlates with tumor volume.
authors.affiliation: Department of Pathology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Bollito
authors.forename: Carlo
authors.initials: C
authors.lastname: Terrone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Volpe
authors.forename: Francesco
authors.initials: F
authors.lastname: Porpiglia
authors.forename: Cecilia
authors.initials: C
authors.lastname: Cracco
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Poggio
authors.forename: Susanna
authors.initials: S
authors.lastname: Grande
authors.forename: Luisella
authors.initials: L
authors.lastname: Righi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bellina
authors.forename: Mauro
authors.initials: M
authors.lastname: Papotti
authors.forename: Roberto Mario
authors.initials: RM
authors.lastname: Scarpa
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology* / Q000601:surgery; D000368:Aged; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D012016:Reference Values; D012669:Seminal Vesicles / Q000473:pathology
chemical_list: D017430:Prostate-Specific Antigen