ERA SPECIFIC BIOCHEMICAL RECURRENCE-FREE SURVIVAL FOLLOWING RADICAL PROSTATECTOMY FOR CLINICALLY LOCALIZED PROSTATE CANCER

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Aug 2001ERA SPECIFIC BIOCHEMICAL RECURRENCE-FREE SURVIVAL FOLLOWING RADICAL PROSTATECTOMY FOR CLINICALLY LOCALIZED PROSTATE CANCER MISOP HAN, ALAN W. PARTIN, STEVEN PIANTADOSI, JONATHAN I. EPSTEIN, and PATRICK C. WALSH MISOP HANMISOP HAN , ALAN W. PARTINALAN W. PARTIN , STEVEN PIANTADOSISTEVEN PIANTADOSI , JONATHAN I. EPSTEINJONATHAN I. EPSTEIN , and PATRICK C. WALSHPATRICK C. WALSH View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65955-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We retrospectively reviewed a large series of men with clinically localized prostate cancer who underwent surgery to define the extent of stage migration and its influence on biochemical recurrence in 3 different eras of prostate cancer management. Materials and Methods: A total of 2,370 men were treated with radical prostatectomy from 1982 to 1998. We analyzed the freedom from biochemical (prostate specific antigen) progression after radical prostatectomy. We compared the distribution of pathological stage by the year of surgery. We then compared the biochemical recurrence-free survival rate according to the different eras that reflect a change in prostate cancer management. Results: There was a significant downward stage migration of prostate cancer and an increasing proportion of men who presented with organ confined disease in recent years. The actuarial biochemical recurrence-free rate was significantly different for patients who underwent surgery between 1982 and 1988, compared with those between 1989 and 1998 (p <0.001). These changes may have reflected the benefits of early detection with prostate specific antigen and digital rectal examination, better preoperative selection of patients for surgery as well as the effect of lead time. Conclusions: Widespread early detection programs for prostate cancer resulted in downward stage migration in men presenting with prostate cancer at our institution during the last 18 years. Also, we have demonstrated a biochemical recurrence-free survival advantage, probably secondary to an improved therapeutic outcome as well as lead time bias, in men who underwent surgery between 1989 and 1998, compared with those between 1982 and 1988. When trying to compare the efficacy of different treatment modalities for prostate cancer, the era in which patients underwent therapy is an important factor to be considered. 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Volume 166Issue 2August 2001Page: 416-419 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsprostatectomyrecurrenceprostatic neoplasmsMetricsAuthor Information MISOP HAN More articles by this author ALAN W. PARTIN Financial interest and/or other relationship with Bayer, Beckman, Cell Pathways, Cytogen and Urologix. More articles by this author STEVEN PIANTADOSI More articles by this author JONATHAN I. EPSTEIN More articles by this author PATRICK C. WALSH More articles by this author Expand All Advertisement PDF downloadLoading ...