Changes in prognostic and therapeutic parameters in prostate cancer from an epidemiological view over 20 years

M. Dörr, A. Schlesinger-Raab, G. Schubert-Fritschle, J. Engel
Munich Cancer Registry (MCR) of the Munich Cancer Centre (MCC)


The aim of this analysis was to examine changes in prognosis and treatment of prostate cancer patients over the last 20 years, and to evaluate their impact on survival.

Patients and Methods

36,008 prostate cancer patients diagnosed between 1990 and 2010 and living in the catchment area of the Munich Cancer Registry (Upper Bavaria and in part Lower Bavaria, population 4.6 million) were analysed.


Pre-therapeutic PSA testing increased dramatically in the early 1990’s. A shift from capsule exceeding tumours to capsule limited tumours also took place especially in the 1990s. In the early 1990s nearly 10% of the diagnosed tumours were stage T4, approximately 35% T3, 23% T2, and circa 13% T1. By 2010 only about 3% of the diagnosed tumours were stage T4, 15% T3, 40% T2 and 23% T1.
Concurrently, initial therapeutic strategies changed noticeably over the last 20 years. Radical prostatectomy increased continuously, from 20% to almost 50% of all initial treatments. Hormone therapy developed oppositely, with initial hormone therapy as the most selected treatment until 1994 and then continuously decreased from 55% in 1990 to 18% in 2010. Radiation therapy and transurethral resection of the prostate slightly increased from about 5 to 10%.
Over the observed time period, 5- and 10-year relative survival improved from 92 to 97% and from 86 to 92%, respectively.


We interpret the small rise in prostate cancer survival rates over the last 20 years, along with the dramatic reversal in tumour staging toward more prognostically favourable T-categories, and noticeable changes in initial therapy strategies as a consequence of overdiagnosis due to the introduction of PSA tests as well as a result of more initial radical prostatectomies.

31. Deutscher Krebskongress, Berlin, 19.-22.2.2014.
Oncology Research and Treatment 2014;37 (suppl.1): 61