Clinicopathologic features of prostate cancer treated with radical prostatectomy:with 650 case report

Abstract

Objective To evaluate the changes in the clinicopathologic features of prostate cancer over the past 10 years and to compare these features with those of Western populations.Methods We had retrospectively reviewed the data of 650 clinically localized prostate cancer patients underwent radical prostatectomy(RP)in our institute from Jan.2002 to Jun.2012.Data included patient's age at surgery,height,weight,body mass index,methods of diagnosis of prostate cancer,preoperative PSA level,neoadjuvant hormonal therapy,comorbidities(hypertension,diabetes mellitus and cardiovascular disease)and pathological characteristics at diagnosis and surgery were collected.257 patients who underwent RP between Jan.2002 and Dec.2009 were classified as the first group,and 393 patients who underwent RP between Jan.2010 and Jun.2012 were classified as the second group.We compared the clinicopathologic variables between these two groups and compared these features with those of Western populations in literature.Results Patients who underwent RP at Fudan University Shanghai Cancer Center increased yearly and it increased rapidly since 2009.The median postoperative pathologic Gleason score was 7 for the entire cohort.105 cases (16.2％)were with positive surgical margins and 88 cases(13.5％)were with pelvic lymph node metastasis.Patients in the second group presented better clinicopathologic parameters when compared with patients in the first group.The average preoperative PSA level of the second group patients(15.8 μg/L)was significantly lower than that of the first group(21.5 μg/L)(P=0.039)and the proportion of patients with not organ-confined disease in the second group(35.6％)was significantly lower than that of the first group(48.6％),P =0.004.Also,the proportion of patients with positive lymph node in the second group(11.2％)was significantly lower than that of the first group(17.1％),P=0.041.When compared with Western population,the proportion of patients with not organ-confined disease in Chinese cohort was significantly higher(40.8％ vs 24.2％-31.0％).In addition,the proportion of patients with positive lymph node was significantly higher(13.5％)than that of Western population(1.4％-3.0％).Conclusions The number of patients received RP increase rapidly and patients present better clinicopathologic parameters currently.However,in comparison,Chinese patients still show relatively worse clinicopathologic features. Key words: Prostatic neoplasms; Radical prostatectomy; Clinicopathologic features