NATIONAL PATTERNS OF PROSTATE-CANCER TREATMENT BY RADICAL PROSTATECTOMY - RESULTS OF A SURVEY BY THE AMERICAN-COLLEGE-OF-SURGEONS COMMISSION-ON-CANCER

To evaluate the patterns of use of radical prostatectomy for the treat ment of prostate cancer in the United States, the American College of Surgeons Commission on Cancer in association with the American Cancer Society and American Urological Association surveyed 484 institutions concerning 2,122 patients treated in 1990. The results revealed that 9 3% of the patients were younger than 75 years when treated. Pretreatme nt prostate specific antigen level was greater than 4.0 ng./ml. in 85. 4% of the patients. Surgical-pathological evaluation showed that 57.5% of the patients treated had American Joint Committee on Cancer pathol ogical stages 0, I and II corresponding to American Urological Associa tion stages A1 to B2. Positive pathological findings, for example micr oscopic tumor extension or invasion, were associated with elevated pro state specific antigen levels at followup. The mortality rate associat ed with the operation was 0.7%. Impotence following treatment was obse rved in 56.6% of the patients who were potent preoperatively and compl ete incontinence was reported in 3.6% of the patients who were previou sly continent. The data may provide benchmarks by which further trends in prostate cancer treatment may be compared.