TY  - JOUR
A1  - Höh, Robert Benedikt
A1  - Preißer, Felix Martin
A1  - Mandel, Philipp
A1  - Wenzel, Mike
A1  - Humke, Clara Julia
A1  - Welte, Maria-Noemi
A1  - Müller, Matthias
A1  - Köllermann, Jens
A1  - Wild, Peter Johannes
A1  - Kluth, Luis A.
A1  - Roos, Frederik
A1  - Chun, Felix
A1  - Becker, Andreas
T1  - Inverse stage migration in radical prostatectomy - a sustaining phenomenon
T2  - Frontiers in Surgery
N2  - 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.
KW  - prostate cancer
KW  - radical prostatecomy
KW  - D’Amico classification
KW  - inverse stage migration
KW  - Gleason score
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/60970
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-609702
SN  - 2296-875X
N1  - 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.
VL  - 8
IS  - art. 612813
SP  - 1
EP  - 7
PB  - Frontiers Media
CY  - Lausanne
ER  -