You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History II1 Apr 2010256 INVERSE STAGE MIGRATION OF ORGAN CONFINED PROSTATE CANCER IN THE 21ST CENTURY IN EUROPE. A RETROSPECTIVE ANALYSIS OF 8346 RADICAL PROSTATECTOMY PATIENTS Jan Spethmann, Hendrick Isbarn, Georg Salomon, Alexander Haese, Hans Heinzer, Hartwig Huland, Thorsten Schlomm, Markus Graefen, and Thomas Steuber Jan SpethmannJan Spethmann More articles by this author , Hendrick IsbarnHendrick Isbarn More articles by this author , Georg SalomonGeorg Salomon More articles by this author , Alexander HaeseAlexander Haese More articles by this author , Hans HeinzerHans Heinzer More articles by this author , Hartwig HulandHartwig Huland More articles by this author , Thorsten SchlommThorsten Schlomm More articles by this author , Markus GraefenMarkus Graefen More articles by this author , and Thomas SteuberThomas Steuber More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.315AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Since the introduction of Prostate specific antigen (PSA) based Prostate cancer (PCa) screening in the US in the early 80th, a significant shift towards organ confined (OC) tumors (“stage migration”) has been observed. We previously reported a parallel trend in a European radical prostatectomy (RP) cohort towards a proportion 55% OC cancers (Noldus et al. Eur Urol 2000) despite the absence of regular PSA testing in Europe. The aim of our present study was to describe the further development and characterize clinical and pathological disease features in the 21st century. METHODS From 1992 to 2008, 8346 patients with clinically localized PCa were treated with RP in a single European institution. Clinical and histopathological characteristics were documented prospectively. We now evaluated these data, stratified by year of surgery in order to describe the stage shift in the present decade. Significance of trend was assessed by chi-square trend test. RESULTS Number of RPs increased from 385 cases per year in 2000 to 1541 per year in 2008. The proportion of OC PCa enlarged to 80% in 2004, followed by an inverse trend until 2008 (66% OC PCa) (p<0.005). Simultaneously, the proportion of pathological low grade PCa (≤ Gleason 3+3) decreased from 56% in 2004 to 25% in 2008 (p<0.005). Combination of PSA, clinical stage and biopsy Gleason Grade into the D′Amico criteria for disease progression following RP revealed an incremental proportion of high risk PCA of 6% in 2004 to17% in 2008 (p<0.005). CONCLUSIONS After a peak in 2004, we observed an inverse migration of OC tumors from 80% to 66% in 2008, the proportion of low-grade PCa decreased to 25%. The influence of focal PCa therapy or active surveillance in low-risk tumors or a change of paradigm in the treatment of “high-risk” PCa may have contributed to this trend in our European RP population. Hamburg, Germany© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e100-e101 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jan Spethmann More articles by this author Hendrick Isbarn More articles by this author Georg Salomon More articles by this author Alexander Haese More articles by this author Hans Heinzer More articles by this author Hartwig Huland More articles by this author Thorsten Schlomm More articles by this author Markus Graefen More articles by this author Thomas Steuber More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...