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The Effect of Evolving Strategies in the Surgical Management of Organ-Confined Prostate Cancer: Comparison of Data from 2005 to 2014 in a Multicenter Setting
INTRODUCTION: The objective of this study was to evaluate changes of patient characteristics and surgical techniques in radical prostatectomy in Germany within the last decade. METHODS: Data from 44 German prostate cancer centers were included in the study. Patients’ characteristics (age, initial PS...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331078/ https://www.ncbi.nlm.nih.gov/pubmed/28054309 http://dx.doi.org/10.1007/s12325-016-0469-4 |
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author | Pohle, Margit Magheli, Ahmed Fischer, Tom Kempkensteffen, Carsten Busch, Jonas Cash, Hannes Miller, Kurt Hinz, Stefan |
author_facet | Pohle, Margit Magheli, Ahmed Fischer, Tom Kempkensteffen, Carsten Busch, Jonas Cash, Hannes Miller, Kurt Hinz, Stefan |
author_sort | Pohle, Margit |
collection | PubMed |
description | INTRODUCTION: The objective of this study was to evaluate changes of patient characteristics and surgical techniques in radical prostatectomy in Germany within the last decade. METHODS: Data from 44 German prostate cancer centers were included in the study. Patients’ characteristics (age, initial PSA value), surgical techniques (open vs. minimally invasive approaches), perioperative parameters (operating time, rate of nerve-sparing (NS) radical prostatectomies (RPs), hospitalization time, catheter indwelling time, surgical margin status, number of dissected lymph nodes (LN)), and pathological findings (tumor stage, Gleason score) were analyzed. RESULTS: Data from 11,675 patients who underwent RP between 2005 and 2014 were analyzed. The rate of open RP approaches decreased by 1.7% (p = 0.0164), the rate of minimally invasive approaches increased by 1.8% (p = 0.0164). Robot-assisted RPs (RARP) increased by 4.6% (p < 0.0001). The number of NS procedures and pelvic lymphadenectomy (LA) increased by 4.5% (p < 0.0001) and 4.7% (p < 0.0001), respectively. Catheter indwelling time and hospitalization time decreased by 1 day (p < 0.0001). No change in the rate of positive surgical margins (p = 0.5061) and the ratio of positive lymph nodes removed (p = 0.4628) was observed. The number of Gleason ≤6 tumors decreased significantly (p < 0.0001). CONCLUSIONS: The number of RARP has significantly increased over the past decade and there is a trend towards surgeries on more advanced tumors with higher yields of lymph nodes dissected. At the same time, the rate of nerve-sparing procedures has significantly increased. |
format | Online Article Text |
id | pubmed-5331078 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-53310782017-03-13 The Effect of Evolving Strategies in the Surgical Management of Organ-Confined Prostate Cancer: Comparison of Data from 2005 to 2014 in a Multicenter Setting Pohle, Margit Magheli, Ahmed Fischer, Tom Kempkensteffen, Carsten Busch, Jonas Cash, Hannes Miller, Kurt Hinz, Stefan Adv Ther Original Research INTRODUCTION: The objective of this study was to evaluate changes of patient characteristics and surgical techniques in radical prostatectomy in Germany within the last decade. METHODS: Data from 44 German prostate cancer centers were included in the study. Patients’ characteristics (age, initial PSA value), surgical techniques (open vs. minimally invasive approaches), perioperative parameters (operating time, rate of nerve-sparing (NS) radical prostatectomies (RPs), hospitalization time, catheter indwelling time, surgical margin status, number of dissected lymph nodes (LN)), and pathological findings (tumor stage, Gleason score) were analyzed. RESULTS: Data from 11,675 patients who underwent RP between 2005 and 2014 were analyzed. The rate of open RP approaches decreased by 1.7% (p = 0.0164), the rate of minimally invasive approaches increased by 1.8% (p = 0.0164). Robot-assisted RPs (RARP) increased by 4.6% (p < 0.0001). The number of NS procedures and pelvic lymphadenectomy (LA) increased by 4.5% (p < 0.0001) and 4.7% (p < 0.0001), respectively. Catheter indwelling time and hospitalization time decreased by 1 day (p < 0.0001). No change in the rate of positive surgical margins (p = 0.5061) and the ratio of positive lymph nodes removed (p = 0.4628) was observed. The number of Gleason ≤6 tumors decreased significantly (p < 0.0001). CONCLUSIONS: The number of RARP has significantly increased over the past decade and there is a trend towards surgeries on more advanced tumors with higher yields of lymph nodes dissected. At the same time, the rate of nerve-sparing procedures has significantly increased. Springer Healthcare 2017-01-04 2017 /pmc/articles/PMC5331078/ /pubmed/28054309 http://dx.doi.org/10.1007/s12325-016-0469-4 Text en © The Author(s) 2017 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Research Pohle, Margit Magheli, Ahmed Fischer, Tom Kempkensteffen, Carsten Busch, Jonas Cash, Hannes Miller, Kurt Hinz, Stefan The Effect of Evolving Strategies in the Surgical Management of Organ-Confined Prostate Cancer: Comparison of Data from 2005 to 2014 in a Multicenter Setting |
title | The Effect of Evolving Strategies in the Surgical Management of Organ-Confined Prostate Cancer: Comparison of Data from 2005 to 2014 in a Multicenter Setting |
title_full | The Effect of Evolving Strategies in the Surgical Management of Organ-Confined Prostate Cancer: Comparison of Data from 2005 to 2014 in a Multicenter Setting |
title_fullStr | The Effect of Evolving Strategies in the Surgical Management of Organ-Confined Prostate Cancer: Comparison of Data from 2005 to 2014 in a Multicenter Setting |
title_full_unstemmed | The Effect of Evolving Strategies in the Surgical Management of Organ-Confined Prostate Cancer: Comparison of Data from 2005 to 2014 in a Multicenter Setting |
title_short | The Effect of Evolving Strategies in the Surgical Management of Organ-Confined Prostate Cancer: Comparison of Data from 2005 to 2014 in a Multicenter Setting |
title_sort | effect of evolving strategies in the surgical management of organ-confined prostate cancer: comparison of data from 2005 to 2014 in a multicenter setting |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331078/ https://www.ncbi.nlm.nih.gov/pubmed/28054309 http://dx.doi.org/10.1007/s12325-016-0469-4 |
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