Stage migration in clinically localized prostate cancer

Objectives: To determine whether migration of pathological tumor stages in patients with clinically localized prostate cancer exists and whether this is due to an increasing frequency of treating patients with clinically insi gnificant cancer. Methods: 1,063 radical retropubic prostatectomies were performed in patient s with clinically localized prostate cancer in one institution within 7.5 y ears (from 1992 until June 1999). All specimens were prospectively processe d according to the Stanford protocol. These were then analyzed regarding th e migration of pathological tumor stages and cancer volumes. Results: With in the observation period, the annual rate of radical retropu bic prostatectomies increased by 225% from 69 to 224 cases. The authors not ed a decline of advanced tumor stages (from 65 to 40%) and an increase in p athological T2 tumors (from 30 to 55%). The rate of small cancers (<0.5 cm( 3)) remained stable between 2 and 5% over the last 5 years. Conclusion: The data confirm trends which were observed in large US centers with increasing detection and treatment of localized prostate cancer witho ut unnecessary treatment of clinically insignificant cancers. Copyright (C) 2000 S. Karger AG, Basel.