naa a22 4500 510740553 CHVBK 20180411083026.0 cr unu---uuuuu 180411e20130901xx s 000 0 eng 10.1007/s11845-013-0920-3 doi (NATIONALLICENCE)springer-10.1007/s11845-013-0920-3 Emerging evidence for Gleason grade migration and distance impact in prostate cancer? An analysis of the rapid access prostate clinic in a tertiary referral center: St. Vincent's University Hospital, Dublin (2009-2011) [Elektronische Daten] [F. O'Kelly, A. Thomas, D. Murray, P. Lee, R. O'Carroll, P. Nicholson, H. Forristal, N. Swan, D. Galvin, D. Mulvin, D. Quinlan] Background: Recent evidence has suggested that the introduction of rapid access prostate cancer programs has led to a more streamlined pathway for patients, and was designed to ultimately reduce referral delays Aims: To identify the initial impact of the introduction of the rapid access prostate clinic on Gleason grading within the prostate cancer cohort, as well as the impact of distance from a tertiary referral center on subsequent Gleason grading Methods: A prospective database was maintained from those men attended the rapid access prostate clinic in St. Vincent's University Hospital. Data relating to demographics, biopsy results, retrospective PSA readings, and subsequent treatment pathways were all recorded and analyzed. Statistical significance was taken at p<0.05 Results: Prospective data from the rapid access prostate clinic illustrated similar results in patient demographics, Gleason grade and choice of treatment outcomes to other published institutions, however, for the first time demonstrate emerging evidence of the effect of the rapid access prostate clinic leading to a downward shift in Gleason grade over a 2-year period, as well as data showing an inverse correlation between leading Gleason grade and distance from our tertiary referral center Conclusion: These results suggest that the introduction of the rapid access prostate clinic has initially begun to demonstrate an initial downgrading in Gleason scoring patterns. Our data also reflects a poorer Gleason score in those patients living further away from the rapid access prostate clinic. This may be in part attributed to a surge in referrals of those patients previously managed outside a tertiary institution, and suggests that patients should undergo prompt referral following suspicion for prostate cancer Royal Academy of Medicine in Ireland, 2013 Prostate cancer nationallicence Gleason grade nationallicence Distance nationallicence Prostate-specific antigen (PSA) nationallicence Rapid access prostate clinic nationallicence Migration nationallicence O'Kelly F. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Thomas A. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Murray D. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Lee P. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut O'Carroll R. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Nicholson P. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Forristal H. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Swan N. Department of Histopathology, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Galvin D. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Mulvin D. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Quinlan D. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut Irish Journal of Medical Science Springer-Verlag 182/3(2013-09-01), 487-491 0021-1265 182:3<487 2013 182 11845 https://doi.org/10.1007/s11845-013-0920-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11845-013-0920-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- O'Kelly F. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Thomas A. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Murray D. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Lee P. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- O'Carroll R. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Nicholson P. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Forristal H. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Swan N. Department of Histopathology, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Galvin D. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Mulvin D. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 700 1- Quinlan D. Department of Urological Surgery, St. Vincent's University Hospital, Elm Park, Dublin 4 aut NATIONALLICENCE 773 0- Irish Journal of Medical Science Springer-Verlag 182/3(2013-09-01), 487-491 0021-1265 182:3<487 2013 182 11845 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer