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Related Concept Videos

Tumor Progression02:07

Tumor Progression

Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Tumor Progression02:07

Tumor Progression

Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...

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Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Pathologic stage migration has slowed in the late PSA era.

Fei Dong1, Alwyn M Reuther, Cristina Magi-Galluzzi

  • 1Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

Urology
|December 11, 2007
PubMed
Summary

Prostate-specific antigen (PSA) screening has shifted prostate cancer staging. While nonorgan-confined disease (NOCD) at prostatectomy has declined, the rate of this stage migration has slowed since 1995.

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Area of Science:

  • Urology
  • Oncology
  • Pathology

Background:

  • Serum prostate-specific antigen (PSA) screening influences clinical and pathologic staging of prostate cancer.
  • Radical prostatectomy is a primary treatment for localized prostate cancer.

Purpose of the Study:

  • To analyze temporal trends in pathologic stage migration.
  • To assess changes in the proportion of nonorgan-confined disease (NOCD) post-prostatectomy.

Main Methods:

  • Evaluation of step-sectioned prostatectomy specimens from 3364 patients treated between 1987 and 2005.
  • Joinpoint regression modeling to identify trend changes in pathologic stage migration.

Main Results:

  • A significant shift towards organ-confined tumors was observed from 1987 to 2005 (P <0.0001).
  • The proportion of patients with NOCD showed trend changes in 1992 and 1995, accelerating after PSA screening implementation.
  • Since 1995, stage migration has slowed, with an annual decrease of 4.2% (P = 0.0027).

Conclusions:

  • The incidence of NOCD at prostatectomy has significantly decreased during the PSA screening era.
  • The recent deceleration in stage migration suggests a reduced impact of PSA screening on pathologic staging.