Abstract
In France, as in other European countries, management of prostate cancer in the population is rather variable. The objective was to analyse diagnosis and treatment modalities of prostate cancer in patients from French cancer registries.
A sample of 803 patients with prostate cancer diagnosed in 1995 was drawn at random from cases recorded in four cancer registries in the geographical regions of Bas-Rhin, Calvados, Isère and Tarn. Diagnosis, clinical staging and treatment were analysed by questionnaire. Multivariate analysis by logistic regression was used to describe medical determinants (age, PSA, clinical staging) of the various treatment choices.
The mean age of the patients was 71.6 y (range 46–94 y). Clinical staging showed 60% T1–2 tumours, 15% T3–4 and 17% N+or metastases. PSA rate (median 18.2 ng/ml) was assessed in 92.4% of patients. Prostate cancer was diagnosed by prostate biopsy in 63% and by transurethral resection of the prostate (TURP) in 32% of patients. The main treatments were radical prostatectomy 22%, radiotherapy 19.4%, hormonal therapy 33%, TURP alone 17.7% and expectant management 6%. The method of treatment was unknown in 5.7% of cases. Adjuvant radiotherapy or hormonal therapy had been used in 31% of cases. Logistic regression analysis showed that radical prostatectomy was most often performed in patients aged <60 y, three times more frequently for T2 tumour and for PSA between 4 and 20 ng/ml. Radiotherapy was the most frequently applied treatment for patients aged between 65 and 75 y, especially in T3 tumours.
Approximately 75% of the patients in the study underwent a specific treatment for prostate cancer with a curative intention in 40%. This study provides a baseline to clinicians and public health authorities on the management of prostate cancer in France with recent data. This survey will be useful to compare future descriptive analysis and to provide data regarding changing clinical practice.
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References
Lu-Yao GL, Greenberg R Changes in prostate cancer incidence and treatment in the USA. Lancet 1994 343 251–254
Ménégoz F et al A recent increase in the incidence of prostatic carcinoma in a French population: role of ultrasonography and prostatic specific antigen. Eur J Cancer 1995 31A 55–58
Chirpaz E et al. Le cancer de la prostate dans les départements de l'Isére et du Tarn entre 1985 et 1995: evolution des indications thérapeutiques. Bull Cancer 1998 85 1049–1054
Coleman MP et al Trends in cancer incidence and mortality. IARC Scientific Publications: Lyons 1993No. 121
Ménégoz F, Chérié-Challine L Le cancer en France: incidence et mortalité. Situation en 1995. Evolution entre 1975 et 1995 La Documentation Française: Paris 1998 182
Grosclaude P et al. Dépistage du cancer de la prostate (II): le cancer de la prostate est-il un problème de santé publique? Actualisation des chiffres d'incidence et de mortalité en France de 1982 à 1990. Prog Urol 1997 7 647–654
Lu-Yao GL, Yao SL Population-based study of long-term survival in patients with clinically localized prostate cancer. Lancet 1997 33 348–353
StataCorp Stata Statistical Software Release. 5.0 college static ed. Stata Corporation: Texas 1997
Maurel J et al Prise en charge thérapeutique du cancer colique en France. Gastroenterol Clin Biol 1998 22 (Suppl 3):S90–S96
Conférence de consensus: le dépistage du cancer localisé de la prostate Rapports et recommandations. Paris, 8–9 December 1989. Ann Urol 1990 24 5–8
Post PN, Darnhuis RA, van der Meyden AP and the Eurocare Working Group Variation in survival of patients with prostate cancer in Europe since 1978. Eur J Cancer 1998 34 2226–2231
Post PN et al Trend and variation in treatment of localized prostate cancer in the southern part of The Netherlands, 1988-1996. Eur Urol 1999 36 175–180
Stamey TA et al Histological and clinical findings in 896 consecutive prostates treated only with radical retropubic prostatectomy: epidemiologic significance of annual changes. J Urol 1998 160 2412–2417
Sandblom G et al. Prostate cancer registration in four Swedish regions 1996. Differences in incidence, age structure and management. Scand J Urol Nephrol 1999 33 306–311
Prior T, Waxman J Editorial. Localized prostate cancer: can we do better? Br Med J 2000 320 70–71
Zincke H et al Radical prostatectomy for clinically localized prostate cancer: long-term results of 1143 patients from a single institution. J Clin Oncol 1994 12 2254–2263
Gerber GS et al. Results of radical prostatectomy in men with clinically localized prostate cancer. Multi-institutional pooled analysis. JAMA 1996 276 615–619
Bagshaw MA, Cox RS, Hancock SL Control of prostate cancer with radiotherapy: long-term results. J Urol 1994 152 1781–1785
Chodak GW et al Results of conservative management of clinically localized prostate cancer. New Engl J Med 1994 330 242–248
Acknowledgements
This study was supported by INSERM (grant no 4M606) and the Association Française d'Urologie. The authors thank Mrs Nina Crowte for translation of the paper.
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Soulié, M., Grosclaude, P., Villers, A. et al. A population-based study on management of prostate cancer in four regions of France. Prostate Cancer Prostatic Dis 4, 154–160 (2001). https://doi.org/10.1038/sj.pcan.4500519
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DOI: https://doi.org/10.1038/sj.pcan.4500519
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