Annual changes in the clinical features of prostatic adenocarcinoma in Taiwan

Authors
Citation
Tt. Wu et Jk. Huang, Annual changes in the clinical features of prostatic adenocarcinoma in Taiwan, BJU INT, 87(1), 2001, pp. 57-60
Citations number
16
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
Journal title
BJU INTERNATIONAL
ISSN journal
1464-4096 → ACNP
Volume
87
Issue
1
Year of publication
2001
Pages
57 - 60
Database
ISI
SICI code
1464-4096(200101)87:1<57:ACITCF>2.0.ZU;2-T
Abstract
Objective To determine, using a clinical and pathological database, the ann ual changes in the characteristics of adenocarcinoma of the prostate diagno sed in consecutive men in Taiwan. Patients and methods All prostatic adenocarcinomas newly diagnosed between 1991 and 1999 in our institution were analysed, Using logistic regression f or dichotomous variables, the annual trends were assessed for changes in th e percentage of Tie disease, incidental carcinoma, clinically localized dis ease and Gleason grade 4/5 cancers. The annual trends for changes in the pa thological features of disease in patients treated by radical prostatectomy were also analysed, Results The study included 694 patients; the median age at diagnosis increa sed significantly (P = 0.004) and there was a significant increase in clini cal Tie disease (relative risk, RR, 1.142, P = 0.022). There were also sign ificant decreases in incidental carcinomas (RR 0.789, P < 0.001), patients with a serum prostate-specific antigen (PSA) level of >20 ng/mL (RR 0.848, P < 0.001) and with Gleason grade 4/5 tumours (RR 0.919, P = 0.005). There was no significant change in the percentage of clinically localized disease , Radical prostatectomy was undertaken in 179 men; the annual incidence of lymph node metastases decreased significantly (P = 0.035) and there was a s ignificant 19% increase in the RR of having organ-confined disease (pT1-2N0 M0) and a 19% decrease in Gleason grade 4/5 tumours. Conclusions These results may reflect the annual trends of prostate cancer in Taiwan in the period for which the PSA assay became available. The incre asing application of PSA testing was associated with a significant increase in clinical Tie disease and decrease in incidental carcinoma. There was al so a significant trend towards less aggressive cancers. Despite the dramati c increase in the annual detection rate, tumours were not detected at an ea rlier stage. However, for patients treated with radical prostatectomy, ther e was a significant change to earlier stage disease and fewer de-differenti ated cancers.