MP09-09 HISTORICAL TRENDS IN HIGH-RISK PROSTATE CANCER PATIENTS CHARACTERISTICS: A 27 YEARS OLD OBSERVATIONAL STUDY FROM A MULTICENTER PROSTATE CANCER CLINICAL AND TRANSLATIONAL RESEARCH GROUP

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II1 Apr 2016MP09-09 HISTORICAL TRENDS IN HIGH-RISK PROSTATE CANCER PATIENTS CHARACTERISTICS: A 27 YEARS OLD OBSERVATIONAL STUDY FROM A MULTICENTER PROSTATE CANCER CLINICAL AND TRANSLATIONAL RESEARCH GROUP Marco Bianchi, Alberto Briganti, Jeffrey R. Karnes, Giorgio Gandaglia, Nicola Fossati, Martin Spahn, Paolo Gontero, Lorenzo Tosco, Burkhard Kneitz, Felix Chun, Emanuele Zaffuto, Dirk De Ridder, Maxine Sun, Markus Graefen, Giansilvio Marchioro, Detlef Frohneberg, Bertrand Guilloneau, Simone Giona, Rafael Sanchez-Salas, Xavier Cathelineau, Pierre Karakiewicz, Hein Van Poppel, Francesco Montorsi, and Steven Joniau Marco BianchiMarco Bianchi More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Jeffrey R. KarnesJeffrey R. Karnes More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Martin SpahnMartin Spahn More articles by this author , Paolo GonteroPaolo Gontero More articles by this author , Lorenzo ToscoLorenzo Tosco More articles by this author , Burkhard KneitzBurkhard Kneitz More articles by this author , Felix ChunFelix Chun More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Dirk De RidderDirk De Ridder More articles by this author , Maxine SunMaxine Sun More articles by this author , Markus GraefenMarkus Graefen More articles by this author , Giansilvio MarchioroGiansilvio Marchioro More articles by this author , Detlef FrohnebergDetlef Frohneberg More articles by this author , Bertrand GuilloneauBertrand Guilloneau More articles by this author , Simone GionaSimone Giona More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , Xavier CathelineauXavier Cathelineau More articles by this author , Pierre KarakiewiczPierre Karakiewicz More articles by this author , Hein Van PoppelHein Van Poppel More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Steven JoniauSteven Joniau More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2296AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent single-institutional studies reported a stage migration towards less aggressive disease at radical prostatectomy (RP) over the last years, even in the context of high risk patients (HRPCa). We verified these trends in a large multi-institutional database (EMPaCT) METHODS We evaluated data of 10,136 patients treated with RP and ePLND at 14 tertiary care centers between 1987 and 2014 for HRPCa. Patients were stratified according to year of surgery (YOS) quintiles (all percentages represent a comparison between the first and last quintile). We estimated biochemical recurrence (BCR) and cancer specific survival (CSS), using the Kaplan-Meier method. We evaluated changes in clinical and pathological features over time. Finally, we evaluated the relationship between YOS and oncological outcomes using Cox regression analyses. Covariates were age at surgery, YOS, pre-operative PSA, pathological T stage, surgical margins status (SM), pathological GS, and lymph node invasion (LNI) RESULTS Mean follow-up time was 180 months (median 126). The 5, 10 and 15-year overall BCR and CSS rates were 61.0, 47.5, 41.2% and 95.8, 90.5 and 84.4%, respectively. From 1987 to 2014, a significant change in clinical stage (cT1 rate:10.4% vs. 40.3%), PSA at surgery (PSA > 20 ng/mL: 8.1 vs. 27.7%) and biopsy GS (GS ≥8-10: 15.3 vs. 44.0%) was observed (all p<0.001). A significant decrease in the rate of positive SM was observed (56.0 vs. 50.0%) while a significant increase in the number of lymph nodes removed was identified through time (more than 15 nodes removed: 35.7 vs. 42.2%; all p<0.001). There was an increase in pathological GS 8-10, LNI and pT3b/pT4 patients (GS 8-10: 12.5 vs. 47.4%; LNI: 24.1 vs. 46.5 %; pT3b/pT4 36.5 vs. 46.2%; all p<0.001). A significant increase in both adjuvant radiotherapy (RT) and adjuvant androgen deprivation therapy (ADT) use was observed (RT: 15.5 vs. 48.8%; ADT 37.5 vs 50.0%; all p<0.001). Year of surgery was significantly associated with BCR (HR per 5-year interval: 0.70, P= 0.02), however no correlation was observed when CSS was assessed (HR per 5-year interval 0.87, 95% CI 0.55-1.41; P = 0.6) CONCLUSIONS Our results demonstrate an increased treatment of more extensive HRPCa over the last two decades. Despite this, better BCR rates and stable cancer specific survival rates were reported, suggesting a possible refinement of surgical approach and more accurate use of multi-modal approach which was able to improve cancer control outcomes over time © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e97 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Marco Bianchi More articles by this author Alberto Briganti More articles by this author Jeffrey R. Karnes More articles by this author Giorgio Gandaglia More articles by this author Nicola Fossati More articles by this author Martin Spahn More articles by this author Paolo Gontero More articles by this author Lorenzo Tosco More articles by this author Burkhard Kneitz More articles by this author Felix Chun More articles by this author Emanuele Zaffuto More articles by this author Dirk De Ridder More articles by this author Maxine Sun More articles by this author Markus Graefen More articles by this author Giansilvio Marchioro More articles by this author Detlef Frohneberg More articles by this author Bertrand Guilloneau More articles by this author Simone Giona More articles by this author Rafael Sanchez-Salas More articles by this author Xavier Cathelineau More articles by this author Pierre Karakiewicz More articles by this author Hein Van Poppel More articles by this author Francesco Montorsi More articles by this author Steven Joniau More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...