A whole of population-based series of radical prostatectomy in Victoria, 1995 to 2000.
OBJECTIVE
Radical prostatectomy (RP) as a first line treatment of prostate cancer was rare prior to the advent of prostate specific antigen (PSA) testing, yet little is known of its use and outcomes in a population setting. We described baseline characteristics of cases in the Victorian Radical Prostatectomy Register (VRPR), investigated possible associations between demographic characteristics and characteristics at diagnosis and at surgery and trends over time.


METHODS
The VRPR is a population-based series of all RPs performed in Victoria from July 1995 to December 2000 (n=2,154).


RESULTS
On average, socio-economic status for cases was higher than for the general Victorian population (34% vs 20% in the highest quintile respectively, p<0.0001). The proportion of PSA-detected cases increased from 53% in 1995 to 79% in 2000 (p for linear trend=0.0004). Age at surgery and PSA levels at diagnosis decreased over time (p=0.006 and p=0.04 respectively). The proportion of cases with Gleason score < or =5 from RP decreased from 35% in 1995 to 14% in 2000, while cases with Gleason score 6-7 increased from 60% to 79%. Similar trends were observed for Gleason score from biopsy. We found little evidence of significant trends over time in other pathological characteristics relevant to prognosis.


CONCLUSIONS
The VRPR provides a unique whole of population based description of radical prostatectomy in Victoria, confirms findings previously reported in single institution clinical series overseas such as migration to younger age at surgery and to Gleason scores 6 to 7, and provides a resource for evaluating RP outcomes in the future.
Bolton
Damien
D
Austin Hospital, Melbourne, Victoria. damien.bolton@unimelb.edu.au
Severi
Gianluca
G
Millar
Jeremy L
JL
Kelsall
Helen
H
Davidson
Adee-Jonathan
AJ
Smith
Charmaine
C
Bagnato
Melisa
M
Pedersen
John
J
Giles
Graham
G
Syme
Rodney
R
D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000302:isolation & purification; D011468:Prostatectomy / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012042:Registries; D012923:Social Class; D014739:Victoria / Q000453:epidemiology
D017430:Prostate-Specific Antigen