Changing nationwide trends away from overtreatment among patients undergoing radical prostatectomy over the past 25 years.
Active surveillance
Overtreatment
Prostate cancer
Radical prostatectomy
Risk classification
Treatment trends
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Jun 2023
Jun 2023
Historique:
received:
28
01
2023
accepted:
07
05
2023
medline:
7
6
2023
pubmed:
17
5
2023
entrez:
17
5
2023
Statut:
ppublish
Résumé
The objective of the current study was to assess whether and how preoperative risk group distribution and pathological outcomes have changed in men treated with radical prostatectomy (RP) over the past 25 years. 11,071 patients from a large contemporary registry-based nationwide cohort with RP as primary treatment between 1995 and 2019 were included. Preoperative risk stratification, postoperative outcomes, and 10 years other-cause mortality (OCM) were analyzed. After 2005, the proportion of low-risk prostate cancer (PCa) decreased from 39.6% to 25.5% in 2010 and decreased further to 15.5% in 2015, and 9.4% in 2019 (p < 0.001). The proportion of high-risk cases increased from 13.1% in 2005 to 23.1% in 2010 and 36.7% in 2015, and 40.4% in 2019 (p < 0.001). After 2005, the proportion of cases with favorable localized PCa decreased from 37.3% to 24.9% in 2010 and decreased further to 13.9% in 2015, and 1.6% in 2019 (p < 0.001). The overall 10 years OCM was 7.7%. The current analysis documents a clear shift in utilization of RP toward higher-risk PCa in men with long life expectancy. Patients with low-risk PCa or favorable localized PCa are rarely operated. This suggests a shift in applying surgery only to patients who may really benefit from RP and the long-standing discussion of overtreatment might become outdated.
Identifiants
pubmed: 37195312
doi: 10.1007/s00345-023-04418-8
pii: 10.1007/s00345-023-04418-8
pmc: PMC10241676
doi:
Substances chimiques
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1497-1502Informations de copyright
© 2023. The Author(s).
Références
Bill-Axelson A, Holmberg L, Garmo H et al (2018) Radical prostatectomy or watchful waiting in prostate cancer—29-year follow-up. N Engl J Med 379:2319–2329
doi: 10.1056/NEJMoa1807801
pubmed: 30575473
Vickers A, Bennette C, Steineck G et al (2012) Individualized estimation of the benefit of radical prostatectomy from the Scandinavian Prostate Cancer Group randomized trial. Eur Urol 62:204–209
doi: 10.1016/j.eururo.2012.04.024
pubmed: 22541389
pmcid: 3389180
Wilt TJ, Brawer MK, Jones KM et al (2012) Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med 367:203–213
doi: 10.1056/NEJMoa1113162
pubmed: 22808955
pmcid: 3429335
Hamdy FC, Donovan JL, Lane JA et al (2016) 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med 375:1415–1424
doi: 10.1056/NEJMoa1606220
pubmed: 27626136
Bokhorst LP, Kranse R, Venderbos LD et al (2015) Differences in treatment and outcome after treatment with curative intent in the screening and control arms of the ERSPC rotterdam. Eur Urol 68:179–182
doi: 10.1016/j.eururo.2014.10.008
pubmed: 25457496
Klotz L, Zhang L, Lam A, Nam R, Mamedov A, Loblaw A (2010) Clinical results of long-term follow-up of a large, active surveillance cohort with localized prostate cancer. J Clin Oncol 28:126–131
doi: 10.1200/JCO.2009.24.2180
pubmed: 19917860
Abdollah F, Sun M, Schmitges J et al (2012) Survival benefit of radical prostatectomy in patients with localized prostate cancer: estimations of the number needed to treat according to tumor and patient characteristics. J Urol 188:73–83
doi: 10.1016/j.juro.2012.03.005
pubmed: 22578732
Briganti A, Joniau S, Gontero P et al (2012) Identifying the best candidate for radical prostatectomy among patients with high-risk prostate cancer. Eur Urol 61:584–592
doi: 10.1016/j.eururo.2011.11.043
pubmed: 22153925
Leyh-Bannurah SR, Karakiewicz PI, Pompe RS et al (2019) Inverse stage migration patterns in North American patients undergoing local prostate cancer treatment: a contemporary population-based update in light of the 2012 USPSTF recommendations. World J Urol 37:469–479
doi: 10.1007/s00345-018-2396-2
pubmed: 29992380
Afferi L, Moschini M, Baumeister P et al (2021) Trends in risk-group distribution and Pentafecta outcomes in patients treated with nerve-sparing, robot-assisted radical prostatectomy: a 10-year low-intermediate volume single-center experience. World J Urol 39:389–397
doi: 10.1007/s00345-020-03206-y
pubmed: 32328779
Leyh-Bannurah SR, Gazdovich S, Budäus L et al (2017) Local therapy improves survival in metastatic prostate cancer. Eur Urol 72:118–124
doi: 10.1016/j.eururo.2017.03.020
pubmed: 28385454
Mathieu R, Korn SM, Bensalah K, Kramer G, Shariat SF (2017) Cytoreductive radical prostatectomy in metastatic prostate cancer: Does it really make sense? World J Urol 35:567–577
doi: 10.1007/s00345-016-1906-3
pubmed: 27502935
van den Bergh R, Gandaglia G, Tilki D et al (2019) Trends in radical prostatectomy risk group distribution in a European multicenter analysis of 28 572 patients: towards tailored treatment. Eur Urol Focus 5:171–178
doi: 10.1016/j.euf.2017.07.003
pubmed: 28801241
Albisinni S, Aoun F, Diamand R et al (2019) Cytoreductive prostatectomy: what is the evidence? A systematic review. Minerva Urol Nefrol 71:1–8
doi: 10.23736/S0393-2249.18.03319-2
pubmed: 30547907
Meissner VH, Strüh JGH, Kron M et al (2020) The role of fatal family history and mode of inheritance in prostate cancer for long-term outcomes following radical prostatectomy. World J Urol. https://doi.org/10.1007/s00345-020-03147-6
doi: 10.1007/s00345-020-03147-6
pubmed: 33048258
pmcid: 8332649
Paiss T, Herkommer K, Chab A et al (2002) [Familial prostate carcinoma in Germany]. Urologe A 41:38–43
doi: 10.1007/s120-002-8229-2
pubmed: 11963773
Mottet N, van den Bergh RCN et al (2021) EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer-2020 update. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 79:243–62
doi: 10.1016/j.eururo.2020.09.042
pubmed: 33172724
Ahmed HU, El-Shater Bosaily A, Brown LC et al (2017) Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 389(10071):815–822
doi: 10.1016/S0140-6736(16)32401-1
pubmed: 28110982
Kasivisvanathan V, Rannikko AS, Borghi M et al (2018) MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med 378(19):1767–1777
doi: 10.1056/NEJMoa1801993
pubmed: 29552975
pmcid: 9084630
van den Bergh RC, Roemeling S, Roobol MJ, Roobol W, Schröder FH, Bangma CH (2007) Prospective validation of active surveillance in prostate cancer: the PRIAS study. Eur Urol 52:1560–1563
doi: 10.1016/j.eururo.2007.05.011
pubmed: 17532115
Roemeling S, Roobol MJ, Postma R et al (2006) Management and survival of screen-detected prostate cancer patients who might have been suitable for active surveillance. Eur Urol 50:475–482
doi: 10.1016/j.eururo.2006.04.019
pubmed: 16713065
Yuh B, Artibani W, Heidenreich A et al (2014) The role of robot-assisted radical prostatectomy and pelvic lymph node dissection in the management of high-risk prostate cancer: a systematic review. Eur Urol 65:918–927
doi: 10.1016/j.eururo.2013.05.026
pubmed: 23721959
Loeb S, Folkvaljon Y, Curnyn C, Robinson D, Bratt O, Stattin P (2017) Uptake of active surveillance for very-low-risk prostate cancer in Sweden. JAMA Oncol 3:1393–1398
doi: 10.1001/jamaoncol.2016.3600
pubmed: 27768168
pmcid: 5559339
Weerakoon M, Papa N, Lawrentschuk N et al (2015) The current use of active surveillance in an Australian cohort of men: a pattern of care analysis from the Victorian Prostate Cancer Registry. BJU Int 115(Suppl 5):50–56
doi: 10.1111/bju.13049
pubmed: 25601201
Malouff T, Mathy NW, Marsh S, Walters RW, Silberstein PT (2017) Trends in the use of radiation therapy for stage IIA prostate cancer from 2004 to 2013: a retrospective analysis using the National Cancer Database. Prostate Cancer Prostatic Dis 20:334–338
doi: 10.1038/pcan.2017.15
pubmed: 28398296
Evers J, Kerkmeijer LGW, van den Bergh RCN et al (2022) Trends and variation in the use of radiotherapy in non-metastatic prostate cancer: a 12-year nationwide overview from the Netherlands. Radiother Oncol 177:134–142
doi: 10.1016/j.radonc.2022.10.028
pubmed: 36328090
Huland H, Graefen M (2015) Changing trends in surgical management of prostate cancer: the end of overtreatment? Eur Urol 68:175–178
doi: 10.1016/j.eururo.2015.02.020
pubmed: 25736732
Froehner M, Koch R, Wirth MP et al (2014) Does increasing life expectancy affect competing mortality after radical prostatectomy? Urol Oncol 32:413–418
doi: 10.1016/j.urolonc.2013.10.006
pubmed: 24332647