Universität zu Köln

Boehm, Katharina, Borgmann, Hendrik, Ebert, Thomas, Hoefner, Thomas, Khaljani, Ehsan, Schmid, Marianne, Schulze-Seemann, Wolfgang, Weib, Peter and Herden, Jan ORCID: 0000-0002-1667-5200 (2021). Stage and Grade Migration in Prostate Cancer Treated With Radical Prostatectomy in a Large German Multicenter Cohort. Clin. Genitourin. Cancer, 19 (2). S. 162 - 168. DALLAS: CIG MEDIA GROUP, LP. ISSN 1938-0682

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Abstract

In 4842 prostate cancer patients undergoing radical prostatectomy between 2000 and 2019, we found a shift toward higher preoperative Gleason score and D'Amico risk groups as well as postoperative stages and grades. This might indicate better patient selection for surgery or be a harbinger of rising mortality and morbidity. Introduction: Overdiagnosis and overtherapy in prostate cancer (PCa) treatment should be avoided, which has led to an awareness of the need to decrease treatment in cases of low-risk PCa with radical prostatectomy (RP). Simultaneously, prostate-specific antigen testing has become less popular in the last few years, which has resulted in higher cancer grade and stage at diagnosis. We evaluated stage and grade migration in the disease of patients treated with RP in a large German cohort. Patients and Methods: Overall, 4842 patients undergoing RP between 2000 and 2019 were included. Age, prostate-specific antigen level, biopsy, and pathologic Gleason score as well as clinical and pathologic stage were collected. D'Amico risk groups and Gleason score were evaluated over different time points. Results: We detected a significant grade migration toward higher grade. The proportion of biopsy Gleason sum <= 6 dropped from 45.8% to 20.6% between <= 2010 and 2017-2019. Further, the proportion of patients with low D'Amico risk scores also decreased by almost 50% (20.8% vs 12.2%). Finally, the proportion of noneorgan-confined PCa increased over time, and the proportion of postoperative Gleason sum <= 6 decreased from 20% to 10% over time. Conclusion: Taken together, data indicate a significant preoperative grade and stage migration toward disease of higher grade in RP-treated PCa. Between the years 2000 and 2019, the proportion of biopsy Gleason sum <= 6 and the proportions of D'Amico low risk disease decreased by approximately 50% (respectively, 45% to 20% and 20.8% to 12.2%). This might indicate better patient selection for RP, but might also be a telltale sign of the rising mortality and morbidity of PCa. (C) 2021 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Boehm, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Borgmann, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Ebert, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoefner, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Khaljani, Ehsan UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmid, Marianne UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulze-Seemann, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Weib, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Herden, Jan UNSPECIFIED orcid.org/0000-0002-1667-5200 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-594595
DOI:	10.1016/j.clgc.2020.12.004
Journal or Publication Title:	Clin. Genitourin. Cancer
Volume:	19
Number:	2
Page Range:	S. 162 - 168
Date:	2021
Publisher:	CIG MEDIA GROUP, LP
Place of Publication:	DALLAS
ISSN:	1938-0682
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MEN; PREDICTION Multiple languages Oncology; Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59459