MP83-06 IS INVERSE STAGE MIGRATION A SUSTAINING PHENOMENON IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY?

Abstract

You have accessJournal of UrologyProstate Cancer: Localized IX1 Apr 2015MP83-06 IS INVERSE STAGE MIGRATION A SUSTAINING PHENOMENON IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY? Andreas Becker, Luis Kluth, Jens Hansen, Christian Meyer, Pierre Tennstedt, Lars Budaeus, Thomas Steuber, and Felix K.H. Chun Andreas BeckerAndreas Becker More articles by this author , Luis KluthLuis Kluth More articles by this author , Jens HansenJens Hansen More articles by this author , Christian MeyerChristian Meyer More articles by this author , Pierre TennstedtPierre Tennstedt More articles by this author , Lars BudaeusLars Budaeus More articles by this author , Thomas SteuberThomas Steuber More articles by this author , and Felix K.H. ChunFelix K.H. Chun More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1881AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A significant patient selection shift towards surgical treatment of D'Amico high risk prostate cancer (PCa) since the early 2000's has been demonstrated in many radical prostatectomy (RP) series. We hypothesize that this inverse stage migration sustained up until today, specifically considering the ongoing debate of RP for low-risk PCa. We aimed to investigate current temporal trends of patient selection for RP according to D'Amico in our prostate cancer. METHODS Between January 2003 and September 2014, 17,766 patients with localized prostate cancer (PCa) underwent open or robotic assisted radical prostatectomy (RP) at our center. Of these 16,725 had complete pre- and postoperative disease characteristics and stratified according to D'Amico's criteria. Chi-squared trend analyses were performed to assess time trends of pre- and postoperative disease characteristics. RESULTS Overall, the number of RPs increased from 546 annual cases in 2003 to 2,052 in 2013 (p<0.001). The proportion of patients undergoing robotic assisted RP increased from 1.4% in 2004 to 35.8% in 2014 (p<0.001). Whereas in 2003, 59.5% of all patients were low-risk according to D'Amico, this proportion continuously decreased to 26.0% in 2014 (p<0.001). Conversely, at the same time, the proportion of high-risk patients increased from 8.4% to 26.3% (p<0.001). The shift to preoperative high-risk characteristics also translated into more advanced histopathologic stages at RP; the proportion of organ confined and Gleason 3+3 disease decreased from 54.2% in 2004 to 11.2% in 2014 (p<0.001). CONCLUSIONS Our results indicate that inverse stage migration from low-risk to high-risk prostate cancer sustained at our center. This trend is potentially attributable to the growing popularity of active surveillance or focal therapy for low-risk PCa and multimodal treatment approaches for high-risk prostate cancer. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1051 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andreas Becker More articles by this author Luis Kluth More articles by this author Jens Hansen More articles by this author Christian Meyer More articles by this author Pierre Tennstedt More articles by this author Lars Budaeus More articles by this author Thomas Steuber More articles by this author Felix K.H. Chun More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...