Prostate cancer treatment in Europe at the end of 1990s

Figures & data

Table I.  Prostate cancer cases by registry, year of diagnosis and age at diagnosis, with proportions of histologically verified cases and population covered by each registry (Source Globocan 2000 [1]).

Registry	Male population covered	No. of cases	Diagnosis period	Age ≥ 70 years (%)	HV* (%)
Slovakia	2609632	435	1996	62	98
Poland
Cracow	349623	261	1996–1998	56	97
Spain
Granada	395087	326	1996–1997	61	87
Italy
Genova	439849	558	1996–1997	67	90
Varese	390267	608	1996–1997	60	93
France
Bas-Rhin	483906	205	1995	56	98
Calvados	306095	199	1995	53	96
Haut-Rhin	341892	194	1995	63	99
Isère	525729	196	1995	62	98
Tarn	166692	197	1995	56	97
The Netherlands
Eindhoven	487625	307	1997–1999	56	99
Overall		3486	1995–1999	60	95

^*HV: histologically verified.

Table II.  Prostate cancer cases according to cancer registry and initial therapy, and percentage of metastatic patients. Analysis performed on 3 486 cases.

	Treatment						M +
Registry	RP1 %	RRT2 %	TURP3 %	Hormone only %	None %	Unknown %	%
Slovakia	19	4	43	23	10	1	43
Poland
Cracow	13	14	10	48	15	0	32
Spain
Granada	11	12	17	45	9	6	22
Italy
Genova	25	14	11	33	11	6	12
Varese	35	3	12	34	15	1	10
France
Bas-Rhin	16	11	35	27	10	1	17
Calvados	19	34	23	20	4	0	16
Haut-Rhin	17	24	19	31	9	0	26
Isère	16	15	45	18	2	4	13
Tarn	37	13	30	14	6	0	15
The Netherlands
Eindhoven	19	36	12	25	7	1	12
Overall	22	14	21	31	10	2	20

¹RP: radical prostatectomy; ²RRT: radical radiotherapy; ³TURP: transurethral resection; M + = distant metastasis at presentation

Table III.  Prostate cancer cases according to initial therapy, age, stage and tumor grade. Analysis performed on 3 407 cases (without cases with unknown treatment).

		Treatment
	N cases (%)	RP^1 %	RRT^2 %	TURP^3 %	Only hormone %	None %
Age (years)
< 60	264 (8)	50	14	15	17	3
60-69	1102 (32)	38	18	18	21	5
70-79	1384 (41)	15	17	24	3411
≥ 80	657 (19)	3	3	26	4820
Stage
T1	552 (16)	16	15	54	8	7
T2	1035 (30)	36	20	14	21	9
T1T2†	287 (8)	9	13	8	4722
T3	416 (12)	34	19	17	26	4
T4	64 (2)	30	6	28	28	8
T3T4¥	66 (2)	9	3	5	7112
N +	135 (4)	51	13	9	25	2
M +	673 (20)	4	8	21	5413
Unknown	179 (5)	8	6	16	4922
Grade
Well diff.	847 (25)	20	15	32	24	9
Mod. Diff.	1583 (46)	30	15	18	29	8
Poorly diff.	498 (15)	17	16	25	36	6
Unknown	479 (14)	8	11	13	4524
Overall	3407 (100)	23	14	22	31	10

¹RP: radical prostatectomy; ²RRT: radical radiotherapy; ³TURP: transurethral resection. For cancers with exact T not available: ^†localized; ^¥advanced

Table IV.  Adjusted relative risks (RR) of radical therapy (radical prostatectomy or radical radiotherapy), with 95% CI, according to registry, age, stage and tumour grade

	RR (95% CI)
Registry
Slovakia	1
Cracow	0.92 (0.69–1.16)
Granada	0.99 (0.75–1.24)
Genova	1.69 (1.36–2.01)
Varese	1.39 (1.12–1.65)
Bas-Rhin	0.93 (0.69–1.17)
Calvados	1.68 (1.33–2.03)
Haut-Rhin	1.41 (1.10–1.72)
Isère	1.09 (0.83–1.36)
Tarn	1.51 (1.20–1.83)
Eindhoven	1.72 (1.40–2.05)
Age (years)
< 60	1.18 (1.08–1.29)
60-69	1
70–79	0.63 (0.57–0.68)
≥ 80	0.14 (0.10–0.18)
Stage
T1	1
T2	1.74 (1.51–1.97)
T1-2†	0.75 (0.57–0.94)
T3	1.58 (1.35–1.81)
T4	1.15 (0.82–1.48)
T3-4¥	0.42 (0.15–0.69)
N +	1.55 (1.27–1.83)
M +	0.48 (0.37–0.59)
Unknown	0.53 (0.33–0.72)
Grade
Well differentiated	1
Moderately differentiated	1.21 (1.10–1.33)
Poorly differentiated	1.07 (0.92–1.22)
Unknown	0.92 (0.75–1.09)

For cancers with exact T not available: ^†localized; ^¥advanced

Table V.  Percentages of patients with low risk and high risk prostate cancer who received radical treatment (radical prostatectomy or radical radiotherapy) within a years of diagnosis by cancer registry (metastatic and N+ cases at diagnosis excluded).

		Radical treatment
Registry		No.	Low risk (%)*	High risk (%)**	Overall (%)
Slovakia		72	36	29	30
Poland	Cracow	62	34	44	36
Spain	Granada	63	22	58	26
Italy
	Genova	183	36	56	39
	Varese	199	27	64	39
France
	Bas-Rhin	52	17	59	32
	Calvados	92	52	73	61
	Haut-Rhin	63	38	79	47
	Isère	56	26	50	35
	Tarn	85	34	77	53
Netherlands	Eindhoven	165	56	75	63
Overall		1092	34	61	41

^*Low risk: well differentiated plus moderately differentiated in patients ≥70 years old

^**High risk: moderately differentiated in patients <70 years, and poorly differentiated

Table VI.  Relative risks (RRs) with 95% CI of patients with low risk and high risk prostate cancers receiving radical treatment (radical prostatectomy or radical radiotherapy) by registry adjusted for age (metastatic and N+ cases at diagnosis excluded).

		Low risk* (1 522 cases)		High risk** (833 cases)
Registry		RR	95%CI	RR	96% CI
Slovakia		1		1
Poland	Cracow	0.82	0.51–1.12	1.43	0.66–2.20
Spain	Granada	0.62	0.40–0.85	1.79	0.94–2.64
Italy
	Genova	1.17	0.85–1.49	1.98	1.15–2.81
	Varese	0.82	0.59–1.06	1.90	1.12–2.69
France
	Bas-Rhin	0.55	0.28–0.82	1.94	1.10–2.77
	Calvados	1.34	0.94–1.74	2.39	1.38–3.41
	Haut-Rhin	1.11	0.75–1.46	2.58	1.54–3.63
	Isère	0.93	0.55–1.30	1.80	0.99–2.61
	Tarn	1.10	0.70–1.50	2.42	1.41–3.44
Netherlands	Eindhoven	1.52	1.13–1.92	2.54	1.50–3.58
Age (years)	<60	1.24	0.98–1.51	1.18	1.07–1.29
	60–69	1		1
	70–79	0.69	0.59–0.79	0.48	0.34–0.61
	≥80	0.11	0.06–0.17	0.11	0.03–0.19

*Low risk: well differentiated plus moderately differentiated in patients ≥70 years old

**High risk: moderately differentiated in patients <70 years, and poorly differentiated

Ferlay, J, Bray, F, Pisani, P, Parkin, DM. Globocan 2000. Cancer incidence, mortality and prevalence worldwide. Lyon: IARC Press; 2001.

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