Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Pohle, Margit, Magheli, Ahmed, Fischer, Tom, Kempkensteffen, Carsten, Busch, Jonas, Cash, Hannes, Miller, Kurt, Hinz, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2017
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
_version_ 1782511306283155456
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
work_keys_str_mv AT pohlemargit theeffectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT magheliahmed theeffectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT fischertom theeffectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT kempkensteffencarsten theeffectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT buschjonas theeffectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT cashhannes theeffectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT millerkurt theeffectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT hinzstefan theeffectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT pohlemargit effectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT magheliahmed effectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT fischertom effectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT kempkensteffencarsten effectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT buschjonas effectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT cashhannes effectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT millerkurt effectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting
AT hinzstefan effectofevolvingstrategiesinthesurgicalmanagementoforganconfinedprostatecancercomparisonofdatafrom2005to2014inamulticentersetting