Comparison of stage migration patterns between Europe and the USA: an analysis of 11 350 men treated with radical prostatectomy for prostate cancer.

TY - JOUR

T1 - Comparison of stage migration patterns between Europe and the USA: an analysis of 11 350 men treated with radical prostatectomy for prostate cancer.

AU - Gallina, Andrea

AU - Chun, Felix

AU - Nazareno, Suardi

AU - Eastham, James A

AU - Perrotte, Paul

AU - Graefen, Markus

AU - Hutterer, Georg

AU - Huland, Hartwig

AU - Klein, Eric A

AU - Reuther, Alwyn

AU - Montorsi, Francesco

AU - Briganti, Alberto

AU - Shariat, Shahrokh F

AU - Roehrborn, Claus G

AU - de La Taille, Alexandre

AU - Salomon, Laurent

AU - Karakiewicz, Pierre I

PY - 2008

Y1 - 2008

N2 - OBJECTIVE: To examine the stage migration patterns in patients treated with radical prostatectomy (RP) for prostate cancer in Europe and in the USA in the last 20 years. PATIENTS AND METHODS: Between 1988 and 2005, RP was performed in 11 350 men: 5739 from Europe and 5611 from the USA. Independent-samples t-test and the chi-square test were, respectively, used for comparisons of means and proportions. The trend test was used to test the statistical significance of trends in proportions over time. RESULTS; Temporal patterns in patients' age, stage and PSA level at presentation were similar on both continents. Conversely, temporal patterns in Gleason sum distribution differed. In the USA, the rate of biopsy Gleason sums of 2-5 decreased from 32.8% to 0.2% (P <0.001), while the rate of Gleason sums of 7 and 8-10 increased (P <0.001). Conversely, in Europe the rate of Gleason sums of 6 increased from 40% to 64% (P <0.001) at the expense of all other Gleason sums. At RP, the rate of Gleason sums of 2-5 decreased on both continents and the rate of a Gleason sum of 7 increased in the USA. Moreover, no important differences in pathological stage trends (organ confinement, extracapsular extension and seminal vesicle invasion) distinguished either population. Finally, the rate of lymph node involvement increased in the USA but remained stable in Europe. CONCLUSIONS: Stage and grade migration affected the USA and Europe to different extents. These differences should be accounted for when prediction tools or comparisons between the USA and Europe are considered.

AB - OBJECTIVE: To examine the stage migration patterns in patients treated with radical prostatectomy (RP) for prostate cancer in Europe and in the USA in the last 20 years. PATIENTS AND METHODS: Between 1988 and 2005, RP was performed in 11 350 men: 5739 from Europe and 5611 from the USA. Independent-samples t-test and the chi-square test were, respectively, used for comparisons of means and proportions. The trend test was used to test the statistical significance of trends in proportions over time. RESULTS; Temporal patterns in patients' age, stage and PSA level at presentation were similar on both continents. Conversely, temporal patterns in Gleason sum distribution differed. In the USA, the rate of biopsy Gleason sums of 2-5 decreased from 32.8% to 0.2% (P <0.001), while the rate of Gleason sums of 7 and 8-10 increased (P <0.001). Conversely, in Europe the rate of Gleason sums of 6 increased from 40% to 64% (P <0.001) at the expense of all other Gleason sums. At RP, the rate of Gleason sums of 2-5 decreased on both continents and the rate of a Gleason sum of 7 increased in the USA. Moreover, no important differences in pathological stage trends (organ confinement, extracapsular extension and seminal vesicle invasion) distinguished either population. Finally, the rate of lymph node involvement increased in the USA but remained stable in Europe. CONCLUSIONS: Stage and grade migration affected the USA and Europe to different extents. These differences should be accounted for when prediction tools or comparisons between the USA and Europe are considered.

M3 - SCORING: Zeitschriftenaufsatz

VL - 101

SP - 1513

EP - 1518

JO - BJU INT

JF - BJU INT

SN - 1464-4096

IS - 12

M1 - 12

ER -