Objectives: We report on the treatment trends and outcomes for prostate cancer in our clinic retrospectively, and compared our data with the domestic clinical mass study for prostate cancer. We then validated the legitimacy of our selected therapy for prostate cancer.
Patients and methods: Eight hundred and eighteen patients at our clinic had histologically confirmed adenocarcinomas of the prostate between January, 2000 and January, 2013.
Results: The age distribution was from 47 to 100 years-old, with a median age of 72 years-old at diagnosis. Clinical TNM staging indicated that 301 cases (36.8%) were stage I, 303 cases (37.0%) were stage II, 101 cases (12.3%) were stage III and 113 cases (13.8%) were stage IV. Three hundred and fifty two cases (43.0%) received some form of androgen deprivation therapy (ADT). Retropubic prostatectomy (RPX) or radiation therapy (RT), including external beam radiation therapy and brachytherapy, was performed in 242 (29.6%) and 136 (16.6%) cases, respectively. The median overall survival was 56.3 months and the respective cause specific 5 year and 10 year survival rates of the 818 cases were 92.0% and 77.8%. Respectively, they were 100% and 100% for T1, 98.7% and 97.4% for T2, 90.7% and 38.5% for T3, and 60.8% and 38.9% for T4. JUA (Japanese Urological Association) Cancer Registration Statistics includes 11,385 eligible cases of prostate cancer, and had the same distribution and the same therapy trends as our data base. NUORG (Nara Uro-oncological Research Group), the data base of 2,303 prostate cancer patients, and our clinical study had the same distribution of D'Amico risk groups. Finally we validated JCAP (Japan Study Group of Prostate Cancer) recommended J-CAPRA scores in our prostate cancer patients who received primary androgen deprivation therapies. Progression free survival and cause specific survival were related to J-CAPRA scores.
Discussion/conclusion: The Japanese prostate cancer patients have higher prostate-specific antigen at diagnosis, higher Gleason score and higher clinical stage than the US patients. The higher rate of primary androgen deprivation therapy is characteristic for the Japanese patients.