Eight year improvement in pathological results after radical prostatectomy

The purpose of this paper is to compare the pathological stage of prostate cancer specimens with preoperative characteristics according to the year of diagnosis. One hundred and seventy five patients underwent radical prostatectomy for l ocalized disease between January 1989 and December 1996. In each year group , the mean preoperative PSA (Prostate Substance Antigen, Hybutech (R) Assay N1 < urgr/ml), digital rectal findings, Gleason grade, pathological stagin g, and postoperative and follow-up PSA values were prospectively recorded a nd compared. The mean PSA value was the only preoperative parameter that significantly f ell with time (from 52-12.2 ngr/ml between 1989 and 1996), and correlated w ith a higher percentage of organ-confined disease (40% vs 81.8%). Biologica l progression one year after radical surgery decreased from 60% in 1989 to 4.5% in 1996. Results of radical prostatectomy are improving with time, corresponding to lower preoperative PSA values. This might result from earlier diagnosis of prostate cancer based on PSA, though the number of insignificant cancers is not increasing.