Prostate cancer diagnosis and management across twenty years of clinical practice: A single-center experience on 2,500 cases

Abstract

Background/Aim: To evaluate the diagnosis and management of prostate cancer (PCa) across twenty years of clinical practice. Materials and Methods: From January 2000 to January 2019, 7,000 patients underwent transperineal prostate biopsy and 990 went through radical prostatectomy, respectively. The clinical and pathological stage in the presence of prostate cancer (PCa) are reported here. Results: The overall number of biopsies increased over time from 1,500 (years 2000-2005) to 2,150 (years 2015-2019). PCa was found in 2,500/7,000 (37.7%) patients while the diagnosis of very low risk PCa increased from 3.2% to 13.6% and diagnosis of metastatic PCa decreased from 12% to 4%. A greater number of men with locally advanced/oligometastatic PCa underwent surgery over time with increasing numbers of nodal involvement and positive surgical margins from 5.4% and 27.2% to 10.8% and 35.6%, respectively. Conclusion: Overtreatment of PCa has been reduced over time by establishing Active Surveillance protocols. Additionally, the multidisciplinar approach has improved the management of locally advanced/oligometastatic PCa.