From the Guidelines
The rate of prostatectomy in the population is approximately 57% for men aged younger than 65 years and 33% for those aged 65 to 74 years, as indicated by initial treatment patterns 1.
Prostatectomy Rates
The prostatectomy rate varies significantly depending on age, geographic location, healthcare access, and screening practices.
- In the United States, the rate is approximately 57% for men aged younger than 65 years and 33% for those aged 65 to 74 years, as indicated by initial treatment patterns 1.
- Age is a significant factor affecting prostatectomy rates, with the highest incidence occurring in men aged 60-70 years.
- Socioeconomic factors also influence access to this procedure, creating disparities in treatment availability across different populations.
Treatment Guidelines
Recent guidelines recommend radical prostatectomy or radiotherapy plus androgen deprivation therapy (ADT) as standard treatment options for patients with high-risk localized prostate cancer 1.
- Clinicians should recommend radical prostatectomy or radiotherapy plus ADT as standard treatment options for patients with high-risk localized prostate cancer 1.
- Active surveillance is not recommended for patients with high-risk localized prostate cancer, and watchful waiting should only be considered in asymptomatic men with limited life expectancy (£5 years) 1.
From the Research
Prostatectomy Rates
- The rate of prostatectomy has increased over time, with a significant rise in the 1980s and 1990s due to the introduction of prostate-specific antigen (PSA) screening 2, 3.
- According to a study published in 1993, the adjusted rate of radical prostatectomy in 1990 was 5.75 times that in 1984 2.
- Another study published in 1999 found that rates of radical prostatectomy more than doubled between 1989 and 1992, but decreased by a third between 1992 and 1995 3.
- A more recent study published in 2021 reported on the outcomes of patients who underwent radical prostatectomy, but did not provide specific rates of prostatectomy 4.
- The rate of prostatectomy varies by age group, with decreases in radical prostatectomy rates observed in elderly persons and increases in younger men 3.
Geographic Variation
- There is substantial geographic variation in rates of radical prostatectomy, with higher rates observed in certain regions such as the Pacific and Mountain regions 2.
- A study published in 1993 found that all states in the New England and Mid-Atlantic regions had rates equal to or below 60 per 100,000 male Medicare beneficiaries, while all states in the Pacific and Mountain regions had rates equal to or above 130 per 100,000 2.
Outcomes
- Radical prostatectomy has been shown to reduce mortality among patients with localized prostate cancer 4.
- A study published in 2021 found that prostate cancer-specific mortality was significantly lower in patients who underwent robot-assisted laparoscopic prostatectomy (RALP) compared to open retropubic radical prostatectomy (RRP) 4.
- Functional outcomes, such as urinary incontinence and erectile dysfunction, were also evaluated in the study, with RALP found to have better outcomes for erectile dysfunction 4.