Temporal Trends in Clinical and Pathological Characteristics for Men Undergoing Radical Prostatectomy Between 1995 and 2013 at Rigshospitalet, Copenhagen, Denmark, and Stanford University Hospital, United States
Temporal Trends in Clinical and Pathological Characteristics for Men Undergoing Radical Prostatectomy Between 1995 and 2013 at Rigshospitalet, Copenhagen, Denmark, and Stanford University Hospital, United States
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DOI：
10.1016/j.clgc.2017.08.014
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发表时间：
2018-02-01
影响因子：
3.2
通讯作者：
Roder, Martin Andreas
中科院分区：
文献类型：
--
作者：
Loft, Mathias Dyrberg;Berg, Kasper Drimer;Roder, Martin Andreas
在丹麦，前列腺特异性抗原（PSA）筛查未被正式推荐用于检测前列腺癌;然而，机会性筛查的使用正在增加。将丹麦哥本哈根Rigshospitalet的2168例丹麦根治性前列腺切除术（RP）患者的临床和病理特征与美国加利福尼亚州斯坦福大学医院的2236例RP患者进行比较，其中PSA筛查正在进行中。尽管建议对PSA筛查在丹麦，丹麦男性在Rigshospitalet进行RP在相当大的程度上，现在类似于美国男性接受RP在斯坦福大学Hospital.Purpose：分析如何前列腺特异性抗原（PSA）筛查和实践模式的影响趋势，在美国和丹麦的男性进行根治性前列腺切除术（RP）的肿瘤特征。与美国不同，丹麦不建议进行PSA筛查。患者和方法：我们使用来自Rigshospitalet，Copenhagen，丹麦的2168名丹麦患者和来自斯坦福大学医院，斯坦福大学，CA的2236名患者的术前和术后数据进行了一项观察性登记研究，这些患者在1995年至2013年期间接受了RP。根据前列腺癌风险评估-术后（CAPRA-S）风险组和D 'Amico风险分类对患者进行分层，并将其分为4个时间段（1995-1999、2000-2004、2005-2009和2010-2013）。采用Cochran-Armitage趋势检验和卡方检验评价了2家机构给定变量患者比例的时间趋势。结果：共纳入4404例患者。在两个队列中均发现了术前PSA、年龄、分级和分期的时间变化。两个队列中的中位术前PSA下降，而中位年龄增加，丹麦队列显示PSA和年龄的变化最大。在这两个队列中，RP前随着时间的推移，存在较高风险术前特征的趋势。2010-2013年，哥本哈根和斯坦福大学分别有27.7%和21.8%的患者属于D 'Amico高危组。结论：尽管建议在丹麦进行PSA筛查，但在Rigshospitalet接受RP的丹麦男性在相当程度上与在斯坦福大学接受RP的美国男性相似。在这两个研究中心，有持续的趋势，以减少男性接受RP的低风险前列腺癌的数量。(C)2017爱思唯尔公司All rights reserved.
Prostate-specific antigen (PSA) screening is not officially recommended for the detection of prostate cancer in Denmark; however, the use of opportunistic screening is rising. Clinical and pathologic characteristics of 2168 Danish radical prostatectomy (RP) patients from Rigshospitalet, Copenhagen, Denmark, were compared with 2236 American RP patients from Stanford University Hospital, Stanford, CA, where PSA screening is ongoing. Despite recommendations against PSA screening in Denmark, Danish men undergoing RP at Rigshospitalet to a considerable extent now resemble American men undergoing RP at Stanford University Hospital.Purpose: To analyze how prostate-specific antigen (PSA) screening and practice patterns has affected trends in tumor characteristics in men undergoing radical prostatectomy (RP) in the United States and Denmark. Unlike in the United States, PSA screening has not been recommended in Denmark. Patients and Methods: We performed an observational register study using pre- and postoperative data on 2168 Danish patients from Rigshospitalet, Copenhagen, Denmark, and 2236 patients from Stanford University Hospital, Stanford, CA, who underwent RP between 1995 and 2013. Patients were stratified according to Cancer of the Prostate Risk Assessment-Postsurgical (CAPRA-S) risk groups and D'Amico risk classification and were clustered into 4 time periods (1995-1999, 2000-2004, 2005-2009, and 2010-2013). Temporal trends in the proportions of patients of a given variable at the 2 institutions were evaluated with Cochran-Armitage test for trends and chi-square testing. Results: A total of 4404 patients were included. Temporal changes in preoperative PSA, age, grade, and stage was found in both cohorts. Median preoperative PSA declined in both cohorts, while median age increased, with the Danish cohort showing the greatest changes in both PSA and age. In both cohorts, there was a trend for higher-risk preoperative features before RP over time. In 2010-2013, 27.7% and 21.8% of the patients were in the D'Amico high-risk group at Copenhagen and Stanford, respectively. Conclusion: Despite recommendation against PSA screening in Denmark, Danish men undergoing RP at Rigshospitalet to a considerable extent now resemble American men undergoing RP at Stanford. At both sites, there is continued trend to reduce the number of men undergoing RP for low-risk prostate cancer. (C) 2017 Elsevier Inc. All rights reserved.