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.

The analysis of histopathological data documented in our database showed a trend towards the surgery of fewer low-risk tumors (Gleason ≤6) and more intermediate- and high-risk tumors over the last 9 years in Germany: the rate of Gleason <6 tumors operated on decreased by 3.1% (4.1% vs. 1.0%, p < 0.0001) and the rate of Gleason 6 tumors by 5.8% (25.3% vs. 19.5%, p < 0.0001) while the rate of Gleason 7b (16.3% vs. 19.7%, p < 0.0001), Gleason 9 (6.1 vs. 10.2%, p < 0.0001), and Gleason 10 (0.2% vs. 0.6%, p = 0.0020) tumors operated on increased significantly.

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This seems to be consistent with other findings in the literature that suggest an overall trend to operate on older patients today than was the case 10–15 years ago: single-center data from a European tertiary-care institution (Martini-Klinik) showed a mean patient age increase of 3 years in men who underwent RP over a time frame of 9 years between 2000 and 2009 [ 13 ].

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