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

被引：128

作者：

Gallina, Andrea ^{[1
,2
]}

Chun, Felix K. -H. ^{[1
,3
]}

Suardi, Nazareno ^{[1
,2
]}

Eastham, James A. ^{[4
]}

Perrotte, Paul ^{[4
]}

Graefen, Markus ^{[3
]}

Hutterer, Georg ^{[1
,7
]}

Huland, Hartwig ^{[3
]}

Klein, Eric A. ^{[6
]}

Reuther, Alwyn ^{[6
]}

Montorsi, Francesco ^{[2
]}

Briganti, Alberto ^{[2
]}

Shariat, Shahrokh F. ^{[5
]}

Roehrborn, Claus G. ^{[5
]}

de la Taille, Alexandre ^{[8
]}

Salomon, Laurent ^{[8
]}

Karakiewicz, Pierre I. ^{[1
]}

机构：

[1] Univ Montreal, Ctr Hlth, Canc Prognost & Hlth Outcomes Unit, Montreal, PQ H2X 3J4, Canada

[2] Univ Vita Salute San Raffaele, Dept Urol, Milan, Italy

[3] Univ Hamburg, Dept Urol, Hamburg, Germany

[4] Mem Sloan Kettering Canc Ctr, Dept Urol, Sidney Kimmel Ctr Prostate & Urol Canc, New York, NY 10021 USA

[5] Univ Texas SW Med Ctr Dallas, Dept Urol, Dallas, TX 75390 USA

[6] Cleveland Clin, Dept Urol, Cleveland, OH 44106 USA

[7] Graz Med Univ, Dept Urol, Graz, Austria

[8] CHU Henri Mondor, AP HP, Dept Urol, F-94010 Creteil, France

来源：

BJU INTERNATIONAL | 2008年 / 101卷 / 12期

关键词：

prostate cancer; stage migration; radical prostatectomy; intercontinental difference;

D O I：

10.1111/j.1464-410X.2008.07519.x

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 [临床医学]; 100201 [内科学];

摘要：

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.

引用

页码：1513 / 1518

页数：6

共 20 条

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