REICAP - PROSPECTIVE EPIDEMIOLOGIC-STUDY OF PROSTATE-CANCER IN ITALY - PRELIMINARY-RESULTS

Objectives: Prostatic carcinoma is a common disease of aging male subj ects. Owing to structural population changes, its incidence is increas ing, making it a major social problem. Epidemiological studies are use ful but often do not fully rely on clinical data. The purpose of the p resent study was to investigate characteristics of prostatic carcinoma from both a clinical and epidemiological point of view. Methods: A mu ltiphased clinicoepidemiological study was initiated in Italy, involvi ng 26 urological centers operating in districts where national tumor r egistries are active. Demographic and clinical data on stage, patholog y, prostate-specific antigen (PSA), and first-line treatment of 819 pa tients recruited during the prospective I-year clinical phase of the s tudy were examined. Results: The study showed that most patients with prostate carcinoma were symptomatic, that incidental cases were 10% an d distant metastases were present at first observation in 15.3% of pat ients. PSA within the normal range was found in about 60% of incidenta l cases and in about a third of stage B cases. Most patients were trea ted with hormonal therapy. Radical surgery showed a limited incidence of capsular involvement and lymph node metastases. Conclusions: These preliminary data show that in Italy, prostate carcinoma is diagnosed m ainly when symptoms are present and that in 53% of cases the disease i s locally advanced or disseminated. Treatment appears quite homogeneou s for advanced cases but controversies exist for stage Al (19% treated with hormones, 23% with radical surgery and 52% with watchful waiting ), for stage A2 (52% treated with hormones, 23% with watchful waiting) , and for stage B (58% of B2 treated with hormones against 27% only tr eated with radical prostatectomy). A special analysis is planned to in vestigate the cause of the low incidence of capsular invasions and D1 in operated cases.