Inverse stage migration in radical prostatectomy - a sustaining phenomenon

  • Objective: To investigate temporal trends in prostate cancer (PCa) radical prostatectomy (RP) candidates. Materials and Methods: Patients who underwent RP for PCa between January 2014 and December 2019 were identified form our institutional database. Trend analysis and logistic regression models assessed RP trends after stratification of PCa patients according to D'Amico classification and Gleason score. Patients with neoadjuvant androgen deprivation or radiotherapy prior to RP were excluded from the analysis. Results: Overall, 528 PCa patients that underwent RP were identified. Temporal trend analysis revealed a significant decrease in low-risk PCa patients from 17 to 9% (EAPC: −14.6%, p < 0.05) and GS6 PCa patients from 30 to 14% (EAPC: −17.6%, p < 0.01). This remained significant even after multivariable adjustment [low-risk PCa: (OR): 0.85, p < 0.05 and GS6 PCa: (OR): 0.79, p < 0.001]. Furthermore, a trend toward a higher proportion of intermediate-risk PCa undergoing RP was recorded. Conclusion: Our results confirm that inverse stage migration represents an ongoing phenomenon in a contemporary RP cohort in a European tertiary care PCa center. Our results demonstrate a significant decrease in the proportion of low-risk and GS6 PCa undergoing RP and a trend toward a higher proportion of intermediate-risk PCa patients undergoing RP. This indicates a more precise patient selection when it comes to selecting suitable candidates for definite surgical treatment with RP.
Author:Robert Benedikt HöhORCiDGND, Felix Martin PreißerORCiDGND, Philipp MandelORCiDGND, Mike WenzelORCiDGND, Clara Julia HumkeGND, Maria-Noemi WelteGND, Matthias Müller, Jens KöllermannORCiDGND, Peter Johannes WildORCiDGND, Luis A. KluthORCiDGND, Frederik RoosGND, Felix ChunORCiDGND, Andreas BeckerGND
Parent Title (English):Frontiers in Surgery
Publisher:Frontiers Media
Place of publication:Lausanne
Document Type:Article
Date of Publication (online):2021/03/01
Date of first Publication:2021/03/01
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/05/17
Tag:D’Amico classification; Gleason score; inverse stage migration; prostate cancer; radical prostatecomy
Issue:art. 612813
Page Number:7
First Page:1
Last Page:7
Copyright © 2021 Hoeh, Preisser, Mandel, Wenzel, Humke, Welte, Müller, Köllermann, Wild, Kluth, Roos, Chun and Becker. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0