title: [Migration of pathological stage after radical prostatectomy to higher risk tumors of relapse: comparative two-center study between 2005 and 2010].
abstract: OBJECTIVE
  With PSA screening, the incidence of prostate cancer (PCa) has increased. Moreover, age and clinical stage have decreased as a result of earlier diagnosis. In this context, the risk of over-treatment including surgery may be important. The objective was to assess the evolution of pathological stages of radical prostatectomy (PR) to 5years apart.
  
  
  METHODS
  Nine hundred and six PR were conducted in two French centers (503 in 2005 and 403 in 2010). Preoperative data (age, PSA, clinical stage, number of biopsies, Gleason score) and postoperative (pTNM, Gleason score, prostate weight) were analyzed and compared (Student test and Chi(2)).
  
  
  RESULTS
  In 2005 and 2010, the median age was respectively 62.85 and 62.52years (NS). The median PSA was 8.55 and 8.99ng/ml (NS). The number of positive biopsies increased significantly (2.30 to 2.88, P<0.0001), but not the biopsy Gleason score (6.34 to 6.43, NS). Clinical stage was significantly changed with T1c: 77.8 to 73%, T2a: 16.6 to 14.2%, T2b: 4 to 7.8%, T2c: 0 to 1%, T3: 1 to 3.9% T4: 0.4 to 0% in 2005 and 2010, respectively (P<0.0006). The average weight of prostate decreased significantly (55.6g versus 48.8g, P<0.0001), pathological Gleason score was unchanged (6.86 versus 6.80, NS). However, the pathological stage has changed significantly to tumours with higher stages pT2: 66.5 to 51.8% and pT3 33.5 to 48.1% (15%) (P=0.02).
  
  
  CONCLUSIONS
  These results have shown that the number of PT performed for pT3 tumours has increased. This increase in patients with high-risk disease has been probably due to change in the selection of patients (surgery for more advanced clinical stages) and allows to consider the radical prostatectomy as a treatment of high risk PCa.
authors.affiliation: Fédération d'urologie, CHU Rangueil, Toulouse cedex, France. jbbeauval@gmail.com
authors.forename: J-B
authors.initials: JB
authors.lastname: Beauval
authors.forename: M
authors.initials: M
authors.lastname: Roumiguié
authors.forename: N
authors.initials: N
authors.lastname: Doumerc
authors.forename: M
authors.initials: M
authors.lastname: Thoulouzan
authors.forename: E
authors.initials: E
authors.lastname: Huyghe
authors.forename: Y
authors.initials: Y
authors.lastname: Allory
authors.forename: C
authors.initials: C
authors.lastname: Mazerolles
authors.forename: A
authors.initials: A
authors.lastname: de la Taille
authors.forename: B
authors.initials: B
authors.lastname: Malavaud
authors.forename: P
authors.initials: P
authors.lastname: Rischmann
authors.forename: M
authors.initials: M
authors.lastname: Soulié
authors.forename: L
authors.initials: L
authors.lastname: Salomon
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D000465:Algorithms; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen