Trend of Radical Prostatectomy and Clinical Pathologic Features of Prostate Cancer: Experience from a Single Tertiary Hospital in the Last Ten Years
JM Gonzalez-Berjon, JY Ro, TM Wheeler, QH Zhai, AG Ayala, SS Shen. The Methodist Hospital and Research Institute, Houston; Baylor College of Medicine, Houston
Background: Radical prostatectomy (RP) is standard treatment for clinically localized prostate cancer and has been proven to provide excellent long-term cancer control in patients with organ confined disease (pT2). Widespread use of PSA screening and biopsy, availability of predictive models and advances in surgical techniques, particularly robotic-assisted laparoscopic procedure has resulted in significant changes in the surgical management of prostate cancer. This study summarizes the trend of radical prostatectomies and clinicopathologic features of prostate cancer in a single hospital in the last ten years.
Design: We reviewed the clinicopathologic data of RP at one tertiary hospital from 1999 to 2008. The cases were divided into three periods: 1999-2002, 2003-2005, and 2006-2008. Type of prostatectomy, patient age, tumor stage (based on 2002 AJCC staging manual), surgical margin, and status of nodal dissection were obtained from hospital records and pathology reports.
Results: Of the 2828 patients with prostate cancer treated by RP, the patient mean age was 60.4 years. Data on tumor pathologic stage, nodal dissection and status, surgical margin, seminal vesical invasion, and type of procedure divided by three periods were summarized in Table 1.
Table 1. Trend of Radical Prostatetomy and Pathologic Feature (1999-2008)*RP-Radical Prostatectomy; LN-lymph node; Nx-no nodal dissection; PSM-positive surgical margin; SVI-seminal vesical invasion
|Years (# cases)||Mean Age||Robotic RP* (%)||pT2 (%)||+LN (%)||Nx* (%)||PSM* (%)||SVI* (%)|
|99-02 (n=985)||60.1||6 (1)||709 (72.0)||12 (1.2)||44 (4.5)||114 (11.6)||62 (6.3)|
|03-05 (n=811)||60.8||125 (15.4)||606 (74.7)||26 (3.2)||165 (20.3)||104 (12.8)||55 (6.8)|
|06-08 (n=1032)||60.4||597 (57.8)||863 (83.6)||25 (2.4)||349 (33.8)||107 (10.4)||66 (6.4)|
Conclusions: da Vinci robotic-assisted laparoscopic RP has been rapidly adopted as the dominant surgical technique for the surgical treatment of prostate cancer. There is continued trend of more localized prostate cancer treated by RP. Less and less patients undergo nodal dissection as a part of RP. However, positive margin rate and incidence of seminal vesicle invasion remains at a constant level. These results suggest that pathologic examination remains the key component for determining the postsurgical treatment plan.
Category: Genitourinary (including renal tumors)
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 123, Wednesday Morning