A whole of population-based series of radical prostatectomy in Victoria, 1995 to 2000
Article first published online: 8 DEC 2009
© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
Australian and New Zealand Journal of Public Health
Volume 33, Issue 6, pages 527–533, December 2009
How to Cite
Bolton, D., Severi, G., Millar, J. L., Kelsall, H., Davidson, A.-J., Smith, C., Bagnato, M., Pedersen, J., Giles, G. and Syme, R. (2009), A whole of population-based series of radical prostatectomy in Victoria, 1995 to 2000. Australian and New Zealand Journal of Public Health, 33: 527–533. doi: 10.1111/j.1753-6405.2009.00448.x
- Issue published online: 8 DEC 2009
- Article first published online: 8 DEC 2009
- Submitted: January 2009 Revision requested: April 2009 Accepted: May 2009
- prostate cancer;
- radical prostatectomy;
- population-based register;
- socio-economic status
Objective: Radical prostatectomy (RP) as a first line treatment of prostate cancer was rare prior to the advent of prostate specific antigen (PSA) testing, yet little is known of its use and outcomes in a population setting. We described baseline characteristics of cases in the Victorian Radical Prostatectomy Register (VRPR), investigated possible associations between demographic characteristics and characteristics at diagnosis and at surgery and trends over time.
Methods: The VRPR is a population-based series of all RPs performed in Victoria from July 1995 to December 2000 (n=2,154).
Results: On average, socio-economic status for cases was higher than for the general Victorian population (34% vs 20% in the highest quintile respectively, p<0.0001). The proportion of PSA-detected cases increased from 53% in 1995 to 79% in 2000 (p for linear trend=0.0004). Age at surgery and PSA levels at diagnosis decreased over time (p=0.006 and p=0.04 respectively). The proportion of cases with Gleason score ≤5 from RP decreased from 35% in 1995 to 14% in 2000, while cases with Gleason score 6-7 increased from 60% to 79%. Similar trends were observed for Gleason score from biopsy. We found little evidence of significant trends over time in other pathological characteristics relevant to prognosis.
Conclusion and Implications: The VRPR provides a unique whole of population based description of radical prostatectomy in Victoria, confirms findings previously reported in single institution clinical series overseas such as migration to younger age at surgery and to Gleason scores 6 to 7, and provides a resource for evaluating RP outcomes in the future.