Prostate cancer. National quality report for the year of diagnosis 2010 from the National Prostate Cancer Register (NPCR)

Transkript

1 Landstingens och regionernas nationella samverkansgrupp inom cancersjukvården Prostate cancer National quality report for the year of diagnosis 10 from the National Prostate Cancer Register (NPCR) May 12

2 Regional cancer centre, Uppsala Örebro University hospital SE UPPSALA 2 Prostatacancer - Nationell kvalitetsrapport, 10

3 List of Tables 1 Number of cases and capture ratio (%) of cases reported to the National Prostate Cancer Register (NPCR) of Sweden by health care region and year, Number of cases and capture ratio (%) in NPCR by county, Number of cases by year of diagnosis and risk category, Main reason for the initiation of the medical investigation that led to the prostate cancer diagnosis, by year of diagnosis, Serum PSA level (µg/l) by year of diagnosis, Number of core biopsies taken per diagnostic session, by year of diagnosis, Number and percentages of patients with the primary treatment type registered within six months following diagnosis, by health care region and year, Type of radical prostatectomy, by year of diagnosis, Type of radical prostatectomy, by hospital, Preoperative nerve sparing intent, by year of diagnosis, Preoperative nerve sparing intent by risk category (low, intermediate, and high risk), Preoperative nerve sparing intent, by hospital, Preoperative nerve sparing intent, by hospital, for low risk category (T1c, Gleason score 6 or less, PSA less than µg/l), Postoperative T-stage (pt-stage), by year of diagnosis, Postoperative T-stage (pt-stage), by hospital, Postoperative T-stage (pt-stage) for preoperative low risk category (T1c, Gleason score 6 or less, PSA less than µg/l), by hospital, Positive surgical margin, by year of diagnosis, Positive surgical margin, by hospital, Positive surgical margin (pt2-tumors), by hospital, Positive surgical margin (intermediate risk tumors), by hospital, Adjuvant therapy following radical prostatectomy, by hospital, Type of radiotherapy, by year of diagnosis, Type of radiotherapy, by hospital, Number of patients with Patient Related Outcome Measures (PROM) data at baseline and one year after treatment (retropubic prostatectomy, robot assisted prostatectomy and external radiotherapy) a Type of hormonal therapy, by hospital, b Type of hormonal therapy, by hospital, 08-10, cont d List of Figures 1 Age-standardized prostate cancer incidence and mortality per men, Time (months) from diagnosis to reporting to the National Prostate Cancer Register for cases diagnosed Time (months) from diagnosis to reporting to the National Prostate Cancer Register for cases diagnosed 10, by health care region Proportion of patients by risk category and year of diagnosis, Proportion of patients by risk category and county, Number of days between date of referral and the first visit at a specialist clinic, by county, 09 and Number of days between date of referral and the first visit at a specialist clinic, by hospital, Prostatacancer - Nationell kvalitetsrapport, 10 3

4 8 Number of days between date of biopsy and date of information to patient, by county, Number of days between date of treatment decision and date of radical prostatectomy, by county, 09 and Number of days between date of treatment decision and date of radical prostatectomy, by hospital, Number of days between date of core biopsies and date of treatment decision in patients with metastatic disease (M1 or PSA 100 µg/l) and treatment with noncurative intent, by county, 09 and Main reason for initiation of work-up leading to prostate cancer diagnosis, by county, Main reason for initiation of work-up leading to prostate cancer diagnosis, by hospital, Serum PSA level at diagnosis, by year, Proportion of men with PSA level between 3 and 4 µg/l, by year of diagnosis, Number of core biopsies at diagnostic session (median number and proportion according to category), by county, Proportion of patients with clinically localized T1-2, PSA less than µg/l and Gleason score 6 or less who underwent bone scintigraphy, by county, 03 and Proportion of patients 75 years or younger at diagnosis with Gleason score 8-10 and/or T3 and/or PSA -50 µg/l that underwent bone scintigraphy, by county, 03 and Proportion of patients older than 75 years at diagnosis with Gleason score 8-10 and/or T3 and/or PSA -50 µg/l that underwent bone scintigraphy, by county, 03 and Treatment strategy, by risk category and year of diagnosis, Treatment strategy for patients 75 years or younger at diagnosis, by risk category and year of diagnosis, Treatment strategy for patients older than 75 years at diagnosis, by risk category and year of diagnosis, Treatment strategy, by risk category and age group, Proportion of men with very low risk tumors (PSA 10 µg/l or less, T1c, Gleason score 6 or less, no more than 2 biopsy cores with cancer, total cancer length in biopsy cores less than 4 mm, age 75 years or younger) that received active surveillance as primary treatment, by county, Proportion of patients with intermediate/high risk tumors (75 years or younger at time of diagnosis) that received treatment with curative intent, by county, Proportion of patients with intermediate/high risk tumors (75 years or younger at time of diagnosis) that received treatment with curative intent, by hospital, Proportion of patients with low risk tumors who underwent radiotherapy that received neoadjuvant hormonal therapy, by county, Proportion of patients with intermediate/high risk tumors who underwent external radiotherapy that received 78 Gy, by county, Type of treatment for patients 75 years or younger at time of diagnosis with locally advanced prostate cancer (T3 or PSA -50 µg/l, not N1 or M1), by county, Type of treatment for patients years of age at time of diagnosis with locally advanced prostate cancer (T3 or PSA -50 µg/l, not N1 or M1), by county, Level of stress urinary incontinence at baseline and one year following treatment according to postal questionnaire Prostatacancer - Nationell kvalitetsrapport, 10

5 32 Level of erectile dysfunction (ED) baseline and one year following treatment according to postal questionnaire year prostate cancer specific mortality among men 70 years or younger with distant metastases at time of diagnosis, by county, Prostatacancer - Nationell kvalitetsrapport, 10 5

6 1 Foreword Each year approximately men are diagnosed with prostate cancer in Sweden. All cases of prostate cancer diagnosed in Sweden are registered in The National Prostate Cancer Register (NPCR) Sweden since 1998 in the six health care regions with a capture ratio of more than 98% compared to The Swedish Cancer Register to which registration is mandatory and regulated by law. NPCR contains data on tumour characteristics and treatment delivered or decided upon up to six months after date of diagnosis. Detailed information on data available in NPCR is found in (1). Since the report for the diagnostic year of 09 that was published in 11 data from each health care provider is reported in NPCR. The data in NPCR is primarily intended to provide a sound basis for quality assurance and bench marking in order to improve care of patients with prostate cancer in Sweden. Data from NPCR are also used for research and a set of linkages between NPCR and other health care registers and demographic databases has been performed in the research project Prostate cancer data Base Sweden (PCBaSe). A full description of these data sets as well as the output from this project was recently published (1). 1. Cohort Profile: The National Prostate Cancer Register (NPCR) of Sweden and Prostate Cancer data Base Sweden (PCBaSe) 2.0. M Van Hemelrijck, A Wigertz, F Sandin, H Garmo, K Hellström, P Fransson, A Widmark, M Lambe, J Adolfsson, E Varenhorst, J-E Johansson, P Stattin for NPCR and PCBaSe Sweden. Int J Epidemiol. PMID May 23, 12 Pär Stattin, Fredrik Sandin, Hans Garmo, Ola Bratt, Anders Widmark, Jan Adolfsson och Jan- Erik Damber for the steering group of NPCR. Fredrik Sandin, Regional cancer center, Uppsala Örebro, performed data management and statistical analysis for this report. Annette Wigertz, Regional cancer center, Uppsala Örebro, coordinated, edited, and proof read this report. 6 Prostatacancer - Nationell kvalitetsrapport, 10

7 Age standardized incidence/mortality per men Incidence Mortality Year Figure 1. Age-standardized prostate cancer incidence and mortality per men, Age-standardized according to the population in Sweden (incidence) or the Nordic countries (mortality) in the year 00. Source: The National Board of Health and Welfare (incidence), and NORDCAN (mortality), Prostatacancer - Nationell kvalitetsrapport, 10 7

8 Table 1. Number of cases and capture ratio (%) of cases reported to the National Prostate Cancer Register (NPCR) of Sweden by health care region and year, North South Stockholm/ Gotland Southeast Uppsala/ Örebro West Total Year of diagnosis (100) 1154 (100) 746 (69) 716 (100) 1370 (98) 1379 (98) 6121 (94) (100) 1333 (99) 1130 (92) 791 (100) 1580 (99) 1487 (99) 7146 (98) (100) 1412 (100) 1187 (84) 776 (100) 1519 (100) 1586 (98) 7226 (96) (100) 1518 (100) 1303 (90) 778 (100) 1587 (100) 1581 (98) 7473 (98) (100) 1482 (99) 1344 (86) 853 (100) 1655 (100) 1470 (99) 7616 (97) (100) 1655 (100) 1698 (95) 905 (100) 1909 (100) 1771 (99) 8852 (99) (100) 1808 (100) 1899 (95) 1030 (100) 22 (100) 1936 (99) 9744 (99) (100) 1793 (99) 1964 (95) 1142 (100) 1980 (100) 1904 (100) 9730 (99) (100) 1697 (99) 1670 (86) 1126 (100) 1917 (100) 1897 (100) 9112 (97) (100) 1627 (98) 1658 (98) 1099 (100) 1826 (100) 1790 (100) 8870 (99) (100) 1734 (98) 1586 (92) 1048 (100) 1829 (100) 1688 (100) 8815 (98) (100) 1867 (99) 14 (96) 1396 (100) 2247 (100) 1939 (100) (99) (100) 1630 (96) 1864 (97) 1227 (99) 1915 (100) 19 (100) 9648 (98) Total (100) 710 (99) 063 (91) (100) (100) (99) (98) 8 Prostatacancer - Nationell kvalitetsrapport, 10

9 Table 2. Number of cases and capture ratio (%) in NPCR by county, 10. Registered in NPCR Total County Jämtland 1 (100) 1 Norrbotten 267 (100) 267 Västerbotten 325 (99) 327 Västernorrland 309 (99) 311 Gävleborg 251 (99) 253 Dalarna 256 (100) 256 Södermanland 268 (100) 269 Uppsala 264 (100) 264 Värmland 232 (100) 232 Västmanland 262 (100) 262 Örebro 264 (100) 264 Västra Götaland 15 (100) 16 Halland 283 (100) 283 Jönköping 374 (100) 374 Kalmar 8 (100) 8 Östergötland 497 (100) 497 Blekinge 175 (100) 175 Kronoberg 245 (100) 245 Skåne 845 (95) 890 Stockholm 713 (99) 722 Gotland 45 (100) 45 Others/private 1952 (95) 51 Prostatacancer - Nationell kvalitetsrapport, 10 9

10 100 Cumulative proportion (%) reported to NPCR % 30.9% 70.5% Number of months since diagnosis Figure 2. Time (months) from diagnosis to reporting to the National Prostate Cancer Register for cases diagnosed Prostatacancer - Nationell kvalitetsrapport, 10

11 100 North 100 South Cumulative proportion (%) reported to NPCR % 18.0% 75.4% Cumulative proportion (%) reported to NPCR % 5.0% 81.2% Number of months since diagnosis Number of months since diagnosis 100 Stockholm/Gotland 100 Southeast Cumulative proportion (%) reported to NPCR % 8.4% 39.5% Cumulative proportion (%) reported to NPCR % 9.8% 77.7% Number of months since diagnosis Number of months since diagnosis 100 Uppsala/Örebro 100 West Cumulative proportion (%) reported to NPCR % 13.8% 77.0% Cumulative proportion (%) reported to NPCR % 16.0% 77.7% Number of months since diagnosis Number of months since diagnosis Figure 3. Time (months) from diagnosis to reporting to the National Prostate Cancer Register for cases diagnosed 10, by health care region. Prostatacancer - Nationell kvalitetsrapport, 10 11

12 Missing 5. Distant metastases 4. Regionally metastatic 3. High risk 2. Intermediate risk 1c. Low risk (missing) 1b. Low risk (B) 1a. Low risk (A) 1. Low risk 0 Figure 4. Proportion of patients by risk category and year of diagnosis, Low risk: T1-2, Gleason score 6 or lower and PSA < 10 µg/l. 1a. Low risk (A): PSA < 10 µg/l, T1c, Gleason score 6 or lower, no more than 2 biopsy cores with cancer, total length of biopsies with cancer < 4mm, age 75. 1b. Low risk (B): Low risk that is not categorized to 1a. 1c. Low risk (missing): Missing information for categorization of low risk according to 1a/b. 2. Intermediate risk: T1-2, Gleason score 7 and/or 10 PSA < µg/l. 3. High risk: T3 and/or Gleason score 8-10 and/or PSA < 50 µg/l. 4. Regionally metastatic: T4 and/or N1 and/or 50 PSA < 100 µg/l, no distant metastases (M0 or MX). 5. Distant metastases: M1 and/or PSA 100 µg/l. 6. Missing: Missing information for categorization according to above. 12 Prostatacancer - Nationell kvalitetsrapport, 10

13 No. of cases Jämtland Norrbotten Västerbotten Västernorrland Gävleborg Dalarna Södermanland Uppsala Värmland Västmanland Örebro Västra Götaland Halland Jönköping Kalmar Östergötland Blekinge Kronoberg Skåne Stockholm Gotland Others/private/missing a. Low risk (A) 1b. Low risk (B) 1c. Low risk (missing) 2. Intermediate risk 3. High risk 4. Regionally metastatic 5. Distant metastases 6. Missing Figure 5. Proportion of patients by risk category and county, 10. Prostatacancer - Nationell kvalitetsrapport, 10 13

14 14 Prostatacancer - Nationell kvalitetsrapport, Low risk Table 3. Number of cases by year of diagnosis and risk category, Intermediate risk 3. High risk 4. Regionally metastatic 5. Distant metastases 6. Missing Total Year of diagnosis (14) 1064 (17) 1785 (29) 709 (12) 1545 (25) 187 (3) (15) 1380 (19) 96 (29) 805 (11) 15 (22) 222 (3) (18) 1441 () 61 (29) 7 (10) 1488 (21) 2 (3) (21) 1524 () 16 (27) 747 (10) 1383 (19) 214 (3) (23) 1626 (21) 21 (27) 700 (9) 1370 (18) 164 (2) (24) 2116 (24) 2281 (26) 764 (9) 12 (16) 195 (2) (28) 2310 (24) 28 (25) 754 (8) 1291 (13) 225 (2) (29) 2380 (24) 2449 (25) 713 (7) 1215 (12) 196 (2) (29) 2297 (25) 2115 (23) 692 (8) 1106 (12) 292 (3) (29) 2312 (26) 24 (23) 645 (7) 1077 (12) 241 (3) (28) 2426 (28) 37 (23) 554 (6) 1084 (12) 234 (3) (28) 3117 (30) 2361 (23) 585 (6) 1176 (11) 278 (3) (28) 29 (30) 2157 (22) 545 (6) 1075 (11) 234 (2) 9648 Total (25) (24) (25) 8953 (8) (15) 2884 (3) Low risk: T1-2, Gleason score 6 or lower and PSA < 10 µg/l. 3. High risk: T3 and/or Gleason score 8-10 and/or PSA < 50 µg/l. 5. Distant metastases: M1 and/or PSA 100 µg/l. 2. Intermediate risk: T1-2, Gleason score 7 and/or 10 PSA < µg/l. 4. Regionally metastatic: T4 and/or N1 and/or 50 PSA < 100 µg/l, no distant metastases (M0 or MX). 6. Missing: Missing information for categorization according to above.

15 No. of cases (10) Median (10) Halland Stockholm Others/private/missing Skåne Västra Götaland Blekinge Södermanland Västerbotten SWEDEN Gotland Örebro Östergötland Jönköping Värmland Kronoberg Västernorrland Norrbotten Uppsala Västmanland Gävleborg Kalmar Dalarna Jämtland Median and interquartile range (days) Figure 6. Number of days between date of referral and the first visit at a specialist clinic, by county, 09 and 10. Prostatacancer - Nationell kvalitetsrapport, 10 15

16 Södersjukhuset Kungsbacka sjukhus Hallands sjukhus Halmstad Danderyds sjukhus Kärnsjukhuset Skövde Borås lasarett Härnösands sjukhus Sahlgrenska Universitetssjukhuset Kalix lasarett Lidköping, (Bas)sjukhuset Mariestads sjukhus Kullbergska sjukhuset Universitetssjukhuset MAS Varbergs sjukhus Lindesbergs lasarett Trelleborgs lasarett Huddinge Karolinska universitetssjukhuset Kiruna lasarett Universitetssjukhuset i Lund Vrinnevisjukhuset i Norrköping Ängelholm, sjukhuset Karolinska sjukhuset Private practice Lycksele lasarett Nyköpings lasarett Others/missing Höglandssjukhuset (Eksjö Nässjö lasarett) Blekingesjukhuset Karlskrona Central sjukhuset i Karlstad Karlshamns lasarett Södertälje sjukhus Värnamo sjukhus (lasarett) Umeå Norrlands universitetssjukhus SWEDEN Simrishamn, sjukhuset Visby lasarett Falköping, Bas(sjukhuset) Helsingsborgs lasarett Kungälvs sjukhus Lundby sjukhus Örebro Universitetssjukhus Mora lasarett Hässleholm, sjukhuset Växjö lasarett Mälarsjukhuset, Eskilstuna Skene lasarett Sundsvalls sjukhus Bollnäs sjukhus Oskarshamns sjukhus (lasarett) Sollefteå sjukhus Hudiksvall Lasarettet i Enköping Uddevalla sjukhus Universitetssjukhuset i Linköping Ystads lasarett Akademiska sjukhuset Alingsås lasarett Centrallasarettet i Västerås Norrtälje sjukhus Sunderby sjukhus Gällivare lasarett Karlskoga lasarett Kalmar länssjukhus Ljungby lasarett Ludvika lasarett Skellefteå lasarett Piteå lasarett Sjukhuset i Torsby Centrum, vårdcentralen Västerviks sjukhus Gävle sjukhus Örnsköldsviks sjukhus S:t Görans sjukhus AB Ryhov, länssjukhuset (Jönköpings lasarett) Sjukhuset i Arvika Östersunds sjukhus Falu lasarett No. of cases Median Median and interquartile range (days) Figure 7. Number of days between date of referral and the first visit at a specialist clinic, by hospital, Prostatacancer - Nationell kvalitetsrapport, 10

17 No. of cases Median Örebro Kronoberg 233 Blekinge Uppsala Jämtland Södermanland Dalarna Skåne Västerbotten Västernorrland Kalmar 2 28 Norrbotten Others/private/missing Västra Götaland SWEDEN Jönköping Värmland Gotland Halland 2 31 Stockholm Gävleborg Östergötland 472 Västmanland Median and interquartile range (days) Figure 8. Number of days between date of biopsy and date of information to patient, by county, 10. Prostatacancer - Nationell kvalitetsrapport, 10 17

18 No. of cases (10) Median (10) Blekinge Others/private/missing Örebro Kalmar Västmanland Gävleborg Södermanland Dalarna Stockholm Västra Götaland SWEDEN Kronoberg Skåne Jönköping Halland Värmland Norrbotten Uppsala Västernorrland Östergötland Gotland Västerbotten Jämtland Median and interquartile range (days) Figure 9. Number of days between date of treatment decision and date of radical prostatectomy, by county, 09 and Prostatacancer - Nationell kvalitetsrapport, 10

19 No. of cases Median Danderyds sjukhus Private practice Lidköping, (Bas)sjukhuset S:t Görans sjukhus AB Västerviks sjukhus Blekingesjukhuset Karlskrona Alingsås lasarett Varbergs sjukhus Örebro Universitetssjukhus Centrallasarettet i Västerås Gävle sjukhus Kärnsjukhuset Skövde Nyköpings lasarett Falu lasarett Lundby sjukhus Mälarsjukhuset, Eskilstuna Södersjukhuset Borås lasarett Helsingsborgs lasarett Others/missing Kalmar länssjukhus Uddevalla sjukhus SWEDEN Huddinge Karolinska universitetssjukhuset Växjö lasarett Karolinska sjukhuset Kristianstad, centralsjukhuset 9 53 Ryhov, länssjukhuset (Jönköpings lasarett) Mariestads sjukhus 1 54 Universitetssjukhuset MAS Central sjukhuset i Karlstad Kungälvs sjukhus Sahlgrenska Universitetssjukhuset Vrinnevisjukhuset i Norrköping Sunderby sjukhus Akademiska sjukhuset Sundsvalls sjukhus Hallands sjukhus Halmstad Visby lasarett Universitetssjukhuset i Linköping Umeå Norrlands universitetssjukhus Östersunds sjukhus Median and interquartile range (days) Figure 10. Number of days between date of treatment decision and date of radical prostatectomy, by hospital, 10. Prostatacancer - Nationell kvalitetsrapport, 10 19

20 No. of cases (10) Median (10) Dalarna Stockholm Örebro Västmanland Västernorrland Södermanland Skåne Halland Jämtland Uppsala SWEDEN Kronoberg Västerbotten Blekinge Jönköping Västra Götaland Others/private/missing Norrbotten Gotland Kalmar Gävleborg Östergötland Värmland Median and interquartile range (days) Figure 11. Number of days between date of core biopsies and date of treatment decision in patients with metastatic disease (M1 or PSA 100 µg/l) and treatment with non-curative intent, by county, 09 and 10. Prostatacancer - Nationell kvalitetsrapport, 10

21 Table 4. Main reason for the initiation of the medical investigation that led to the prostate cancer diagnosis, by year of diagnosis, Health control LUTS Other symptoms/ other reason Missing Total Year of diagnosis (28) 3468 (36) 3099 (32) 2 (4) (28) 4114 (42) 2383 (24) 506 (5) (28) 3927 (43) 2122 (23) 486 (5) (33) 3674 (41) 1901 (21) 398 (4) (35) 3639 (41) 1783 () 327 (4) (42) 3814 (36) 1909 (18) 322 (3) (42) 3434 (36) 1897 () 245 (3) 9648 Prostatacancer - Nationell kvalitetsrapport, 10 21

22 No. of cases Jämtland Norrbotten Västerbotten Västernorrland Gävleborg Dalarna Södermanland Uppsala Värmland Västmanland Örebro Västra Götaland Halland Jönköping Kalmar Östergötland Blekinge Kronoberg Skåne Stockholm Gotland Others/private/missing SWEDEN Health control LUTS Other symptoms Missing Figure 12. Main reason for initiation of work-up leading to prostate cancer diagnosis, by county, Prostatacancer - Nationell kvalitetsrapport, 10

23 No. of cases Stockholm/Gotland South Southeast West Uppsala/Örebro North Gällivare lasarett Härnösands sjukhus Kalix lasarett Kiruna lasarett Lycksele lasarett Piteå lasarett Skellefteå lasarett Sollefteå sjukhus Sunderby sjukhus Sundsvalls sjukhus Umeå Norrlands universitetssjukhus Örnsköldsviks sjukhus Östersunds sjukhus Private practice Others/missing Akademiska sjukhuset Bollnäs sjukhus Central sjukhuset i Karlstad Centrallasarettet i Västerås Falu lasarett Gävle sjukhus Hudiksvall Karlskoga lasarett Kullbergska sjukhuset Lasarettet i Enköping Lindesbergs lasarett Ludvika lasarett Mora lasarett Mälarsjukhuset, Eskilstuna Nyköpings lasarett Sjukhuset i Arvika Sjukhuset i Torsby Örebro Universitetssjukhus Private practice Alingsås lasarett Borås lasarett Centrum, vårdcentralen Falköping, Bas(sjukhuset) Kungsbacka sjukhus Kungälvs sjukhus Kärnsjukhuset Skövde Lidköping, (Bas)sjukhuset Lundby sjukhus Mariestads sjukhus Sahlgrenska Universitetssjukhuset Skene lasarett Uddevalla sjukhus Varbergs sjukhus Private practice Höglandssjukhuset (Eksjö Nässjö lasarett) Kalmar länssjukhus Oskarshamns sjukhus (lasarett) Ryhov, länssjukhuset (Jönköpings lasarett) Universitetssjukhuset i Linköping Vrinnevisjukhuset i Norrköping Värnamo sjukhus (lasarett) Västerviks sjukhus Private practice Others/missing Blekingesjukhuset Karlskrona Hallands sjukhus Halmstad Helsingsborgs lasarett Hässleholm, sjukhuset Karlshamns lasarett Kristianstad, centralsjukhuset Ljungby lasarett Simrishamn, sjukhuset Trelleborgs lasarett Universitetssjukhuset i Lund Universitetssjukhuset MAS Växjö lasarett Ystads lasarett Ängelholm, sjukhuset Private practice Others/missing Danderyds sjukhus Huddinge Karolinska universitetssjukhuset Karolinska sjukhuset Norrtälje sjukhus S:t Görans sjukhus AB Södersjukhuset Södertälje sjukhus Visby lasarett Private practice Others/missing SWEDEN Health control LUTS Other symptoms Missing Figure 13. Main reason for initiation of work-up leading to prostate cancer diagnosis, by hospital, 10. Prostatacancer - Nationell kvalitetsrapport, 10 23

24 Table 5. Serum PSA level (µg/l) by year of diagnosis, Median First quartile Third quartile Missing (%) Total Year of diagnosis (4) (4) (3) (3) (2) (2) (2) (2) (3) (2) (2) (2) (2) 9648 Total (2) Prostatacancer - Nationell kvalitetsrapport, 10

25 PSA < 3 3 PSA<4 4 PSA<10 10 PSA< PSA<100 PSA 100 Missing Figure 14. Serum PSA level at diagnosis, by year, Figure 15. Proportion of men with PSA level between 3 and 4 µg/l, by year of diagnosis, Prostatacancer - Nationell kvalitetsrapport, 10 25

26 Table 6. Number of core biopsies taken per diagnostic session, by year of diagnosis, Median < Missing Total Year of diagnosis (8) 4169 (58) 1641 (23) 76 (1) 783 (11) (7) 88 (46) 3156 (36) 109 (1) 874 (10) (6) 3755 (36) 5041 (48) 211 (2) 899 (9) (5) 2893 (30) 5102 (53) 330 (3) 850 (9) 9648 The Stockholm/Gotland region is excluded for 07. No. of cases Median Jämtland Norrbotten Västerbotten Västernorrland Gävleborg Dalarna Södermanland Uppsala Värmland Västmanland Örebro Västra Götaland Halland Jönköping Kalmar Östergötland Blekinge Kronoberg Skåne Stockholm Gotland Others/private/missing SWEDEN < Missing Figure 16. Number of core biopsies at diagnostic session (median number and proportion according to category), by county, Prostatacancer - Nationell kvalitetsrapport, 10

27 No. of cases Jämtland Norrbotten Västerbotten Västernorrland Gävleborg Dalarna Södermanland Uppsala Värmland Västmanland Örebro Västra Götaland Halland Jönköping Kalmar Östergötland Blekinge Kronoberg Skåne Stockholm Gotland Others/private/missing SWEDEN Figure 17. Proportion of patients with clinically localized T1-2, PSA less than µg/l and Gleason score 6 or less who underwent bone scintigraphy, by county, 03 and 10. Prostatacancer - Nationell kvalitetsrapport, 10 27

28 No. of cases Jämtland Norrbotten Västerbotten Västernorrland Gävleborg Dalarna Södermanland Uppsala Värmland Västmanland Örebro Västra Götaland Halland Jönköping Kalmar Östergötland Blekinge Kronoberg Skåne Stockholm Gotland Others/private/missing SWEDEN Figure 18. Proportion of patients 75 years or younger at diagnosis with Gleason score 8-10 and/or T3 and/or PSA -50 µg/l that underwent bone scintigraphy, by county, 03 and Prostatacancer - Nationell kvalitetsrapport, 10

29 No. of cases Jämtland Norrbotten Västerbotten Västernorrland Gävleborg Dalarna Södermanland Uppsala Värmland Västmanland Örebro Västra Götaland Halland Jönköping Kalmar Östergötland Blekinge Kronoberg Skåne Stockholm Gotland Others/private/missing SWEDEN Figure 19. Proportion of patients older than 75 years at diagnosis with Gleason score 8-10 and/or T3 and/or PSA -50 µg/l that underwent bone scintigraphy, by county, 03 and 10. Prostatacancer - Nationell kvalitetsrapport, 10 29

30 Table 7. Number and percentages of patients with the primary treatment type registered within six months following diagnosis, by health care region and year, North South Stockholm/ Gotland Southeast Uppsala/ Örebro West Total Year of diagnosis (100) 1510 (93) 1364 (82) 1094 (100) 1814 (99) 1754 (98) 83 (95) (99) 1718 (99) 1442 (91) 1009 (96) 1821 (100) 1688 (100) 81 (98) (99) 1850 (99) 1958 (97) 1393 (100) 2241 (100) 1939 (100) 104 (99) (98) 1614 (99) 1809 (97) 1172 (96) 1902 (99) 1939 (100) 9491 (98) 30 Prostatacancer - Nationell kvalitetsrapport, 10

31 Low risk Intermediate risk Conservative therapy Curative therapy Hormonal therapy 0 Conservative therapy Curative therapy Hormonal therapy High risk Regionally metastatic Conservative therapy Curative therapy Hormonal therapy 0 Conservative therapy Curative therapy Hormonal therapy Distant metastases Conservative therapy Curative therapy Hormonal therapy Figure. Treatment strategy, by risk category and year of diagnosis, Prostatacancer - Nationell kvalitetsrapport, 10 31

32 Low risk Intermediate risk Active surveillance Watchful waiting Curative therapy Hormonal therapy 0 Active surveillance Watchful waiting Curative therapy Hormonal therapy High risk Regionally metastatic Active surveillance Watchful waiting Curative therapy Hormonal therapy 0 Active surveillance Watchful waiting Curative therapy Hormonal therapy Distant metastases Active surveillance Watchful waiting Curative therapy Hormonal therapy Figure 21. Treatment strategy for patients 75 years or younger at diagnosis, by risk category and year of diagnosis, Prostatacancer - Nationell kvalitetsrapport, 10

33 Low risk Intermediate risk Active surveillance Watchful waiting Curative therapy Hormonal therapy 0 Active surveillance Watchful waiting Curative therapy Hormonal therapy High risk Regionally metastatic Active surveillance Watchful waiting Curative therapy Hormonal therapy 0 Active surveillance Watchful waiting Curative therapy Hormonal therapy Distant metastases Active surveillance Watchful waiting Curative therapy Hormonal therapy Figure 22. Treatment strategy for patients older than 75 years at diagnosis, by risk category and year of diagnosis, Prostatacancer - Nationell kvalitetsrapport, 10 33

34 Low risk Intermediate risk < < Active surveillance Watchful waiting Curative therapy Hormonal therapy 0 Active surveillance Watchful waiting Curative therapy Hormonal therapy High risk Regionally metastatic < < Active surveillance Watchful waiting Curative therapy Hormonal therapy 0 Active surveillance Watchful waiting Curative therapy Hormonal therapy Distant metastases 80 < Active surveillance Watchful waiting Curative therapy Hormonal therapy Figure 23. Treatment strategy, by risk category and age group, Prostatacancer - Nationell kvalitetsrapport, 10

35 No. of cases Jämtland Norrbotten Västerbotten Västernorrland Gävleborg Dalarna Södermanland Uppsala Värmland Västmanland Örebro Västra Götaland Halland Jönköping Kalmar Östergötland Blekinge Kronoberg Skåne Stockholm Gotland Others/private/missing SWEDEN Age Age > Figure 24. Proportion of men with very low risk tumors (PSA 10 µg/l or less, T1c, Gleason score 6 or less, no more than 2 biopsy cores with cancer, total cancer length in biopsy cores less than 4 mm, age 75 years or younger) that received active surveillance as primary treatment, by county, 10. Prostatacancer - Nationell kvalitetsrapport, 10 35

36 No. of cases Jämtland Norrbotten Västerbotten Västernorrland Gävleborg Dalarna Södermanland Uppsala Värmland Västmanland Örebro Västra Götaland Halland Jönköping Kalmar Östergötland Blekinge Kronoberg Skåne Stockholm Gotland Others/private/missing SWEDEN Figure 25. Proportion of patients with intermediate/high risk tumors (75 years or younger at time of diagnosis) that received treatment with curative intent, by county, Prostatacancer - Nationell kvalitetsrapport, 10

37 No. of cases Stockholm/Gotland South Southeast West Uppsala/Örebro North Gällivare lasarett Härnösands sjukhus Kalix lasarett Lycksele lasarett Piteå lasarett Skellefteå lasarett Sollefteå sjukhus Sunderby sjukhus Sundsvalls sjukhus Umeå Norrlands universitetssjukhus Örnsköldsviks sjukhus Östersunds sjukhus Private practice Akademiska sjukhuset Bollnäs sjukhus Central sjukhuset i Karlstad Centrallasarettet i Västerås Falu lasarett Gävle sjukhus Hudiksvall Karlskoga lasarett Kullbergska sjukhuset Lasarettet i Enköping Lindesbergs lasarett Ludvika lasarett Mora lasarett Mälarsjukhuset, Eskilstuna Nyköpings lasarett Sjukhuset i Arvika Sjukhuset i Torsby Örebro Universitetssjukhus Private practice Alingsås lasarett Borås lasarett Centrum, vårdcentralen Falköping, Bas(sjukhuset) Kungsbacka sjukhus Kungälvs sjukhus Kärnsjukhuset Skövde Lidköping, (Bas)sjukhuset Lundby sjukhus Mariestads sjukhus Sahlgrenska Universitetssjukhuset Skene lasarett Uddevalla sjukhus Varbergs sjukhus Private practice Höglandssjukhuset (Eksjö Nässjö lasarett) Kalmar länssjukhus Oskarshamns sjukhus (lasarett) Ryhov, länssjukhuset (Jönköpings lasarett) Universitetssjukhuset i Linköping Vrinnevisjukhuset i Norrköping Värnamo sjukhus (lasarett) Västerviks sjukhus Private practice Others/missing Blekingesjukhuset Karlskrona Hallands sjukhus Halmstad Helsingsborgs lasarett Hässleholm, sjukhuset Karlshamns lasarett Kristianstad, centralsjukhuset Ljungby lasarett Simrishamn, sjukhuset Trelleborgs lasarett Universitetssjukhuset i Lund Universitetssjukhuset MAS Växjö lasarett Ystads lasarett Ängelholm, sjukhuset Private practice Danderyds sjukhus Huddinge Karolinska universitetssjukhuset Karolinska sjukhuset Norrtälje sjukhus S:t Görans sjukhus AB Södersjukhuset Södertälje sjukhus Visby lasarett Private practice Others/missing SWEDEN Figure 26. Proportion of patients with intermediate/high risk tumors (75 years or younger at time of diagnosis) that received treatment with curative intent, by hospital, 10. Prostatacancer - Nationell kvalitetsrapport, 10 37

38 Table 8. Type of radical prostatectomy, by year of diagnosis, Retropubic Laparoscopic Robot assisted Laparoscopic/ robot assisted Total Year of diagnosis (100) 0 (0) (100) 0 (0) (98) 12 (2) (95) 49 (5) (89) 126 (11) (84) 244 (16) (85) 328 (15) (78) 486 (22) (72) 558 (28) (55) 121 (5) 875 (39) 996 (45) (48) 123 (4) 1319 (47) 1442 (52) (49) 110 (5) 1105 (46) 1215 (51) The information is not available for Stockholm for 07, and this year is therefore excluded from the table. 38 Prostatacancer - Nationell kvalitetsrapport, 10

39 Table 9. Type of radical prostatectomy, by hospital, Retropubic Laparoscopic Robot assisted laparoscopic Total North Sunderby sjukhus 33 (100) 0 (0) 0 (0) 33 Sundsvalls sjukhus 30 (100) 0 (0) 0 (0) 30 Umeå - Norrlands universitetssjukhus 153 (99) 2 (1) 0 (0) 155 Östersunds sjukhus 86 (99) 1 (1) 0 (0) 87 Private practice 1 (100) 0 (0) 0 (0) 1 Others/missing 0 (0) 0 (0) 1 (100) 1 Uppsala/Örebro Akademiska sjukhuset 92 (47) 105 (53) 0 (0) 197 Central sjukhuset i Karlstad 49 (35) 91 (65) 0 (0) 1 Centrallasarettet i Västerås 139 (99) 0 (0) 1 (1) 1 Falu lasarett 74 (100) 0 (0) 0 (0) 74 Gävle sjukhus 82 (100) 0 (0) 0 (0) 82 Kullbergska sjukhuset 1 (100) 0 (0) 0 (0) 1 Mälarsjukhuset, Eskilstuna () 78 (80) 0 (0) 98 Nyköpings lasarett 72 (100) 0 (0) 0 (0) 72 Örebro Universitetssjukhus 125 (99) 1 (1) 0 (0) 126 Others/missing 1 (50) 0 (0) 1 (50) 2 West Alingsås lasarett 106 (98) 2 (2) 0 (0) 108 Borås lasarett 152 (100) 0 (0) 0 (0) 152 Kungälvs sjukhus 59 (100) 0 (0) 0 (0) 59 Kärnsjukhuset Skövde 138 (100) 0 (0) 0 (0) 138 Lidköping, (Bas)sjukhuset (100) 0 (0) 0 (0) Lundby sjukhus 131 (100) 0 (0) 0 (0) 131 Mariestads sjukhus 1 (100) 0 (0) 0 (0) 1 Sahlgr Univ Sjh/Östra 0 (0) 0 (0) 1 (100) 1 Sahlgrenska Universitetssjukhuset 111 (23) 0 (0) 365 (77) 476 Uddevalla sjukhus 214 (100) 0 (0) 1 (0) 215 Varbergs sjukhus 27 (15) 1 (1) 148 (84) 176 Private practice 224 (100) 0 (0) 1 (0) 225 Others/missing 4 (50) 1 (12) 3 (38) 8 Southeast Höglandssjukhuset (Eksjö-Nässjö lasarett) 5 (100) 0 (0) 0 (0) 5 Kalmar länssjukhus 5 (100) 1 (0) 0 (0) 6 Oskarshamns sjukhus (lasarett) 1 (100) 0 (0) 0 (0) 1 Ryhov, länssjukhuset (Jönköpings lasarett) 22 (9) 7 (3) 7 (88) 236 Universitetssjukhuset i Linköping 22 (9) 2 (1) 221 (90) 245 Vrinnevisjukhuset i Norrköping 77 (100) 0 (0) 0 (0) 77 Västerviks sjukhus 88 (100) 0 (0) 0 (0) 88 Private practice 2 (100) 0 (0) 0 (0) 2 Others/missing 1 (25) 0 (0) 3 (75) 4 South Blekingesjukhuset Karlskrona 152 (100) 0 (0) 0 (0) 152 Hallands sjukhus - Halmstad (21) 0 (0) 149 (79) 189 Helsingsborgs lasarett 175 (99) 1 (1) 1 (1) 177 Kristianstad, centralsjukhuset 65 (98) 0 (0) 1 (2) 66 Universitetssjukhuset i Lund 16 (9) 1 (1) 159 (90) 176 Universitetssjukhuset MAS 33 (5) 3 (0) 610 (94) 646 Växjö lasarett 90 (100) 0 (0) 0 (0) 90 Others/missing 0 (0) 0 (0) 4 (100) 4 Stockholm/Gotland Danderyds sjukhus 121 (100) 0 (0) 0 (0) 121 Huddinge - Karolinska universitetssjukhuset 193 (99) 0 (0) 1 (1) 194 Karolinska sjukhuset 17 (1) 53 (5) 1086 (94) 1156 S:t Görans sjukhus AB 0 (0) 1 (0) 331 (100) 332 Södersjukhuset 93 (99) 0 (0) 1 (1) 94 Visby lasarett 47 (100) 0 (0) 0 (0) 47 Private practice 69 (96) 3 (4) 0 (0) 72 Others/missing 57 (95) 0 (0) 3 (5) SWEDEN Total 3756 (51) 354 (5) 3299 (45) 79

40 Table 10. Preoperative nerve sparing intent, by year of diagnosis, Yes, bilateral Yes, unilateral No Missing Total Year of diagnosis (31) 582 (26) 661 (30) 306 (14) (29) 832 (30) 769 (28) 3 (13) (29) 671 (28) 7 (25) 4 (18) Table 11. Preoperative nerve sparing intent by risk category (low, intermediate, and high risk), Yes, bilateral Yes, unilateral No Missing Total Risk group 1. Low risk 1249 (44) 787 (28) 441 (15) 376 (13) Intermediate risk 796 (24) 10 (31) 1023 (30) 493 (15) High risk 108 (11) 196 (21) 479 (51) 159 (17) 942 Prostatacancer - Nationell kvalitetsrapport, 10

41 Table 12. Preoperative nerve sparing intent, by hospital, Yes, bilateral Yes, unilateral No Missing Total North Sunderby sjukhus 0 (0) 2 (6) 9 (27) 22 (67) 33 Sundsvalls sjukhus 11 (37) 5 (17) 6 () 8 (27) 30 Umeå - Norrlands universitetssjukhus 45 (29) 30 (19) 11 (7) 69 (45) 155 Östersunds sjukhus 44 (51) 13 (15) 7 (8) 23 (26) 87 Private practice 1 (100) 0 (0) 0 (0) 0 (0) 1 Others/missing 0 (0) 0 (0) 0 (0) 1 (100) 1 Uppsala/Örebro Akademiska sjukhuset 76 (39) 68 (35) 34 (17) 19 (10) 197 Central sjukhuset i Karlstad 23 (16) 52 (37) 59 (42) 6 (4) 1 Centrallasarettet i Västerås 31 (22) 36 (26) 38 (27) 35 (25) 1 Falu lasarett 5 (7) 26 (35) 10 (14) 33 (45) 74 Gävle sjukhus 7 (9) 8 (10) 17 (21) 50 (61) 82 Kullbergska sjukhuset 0 (0) 0 (0) 0 (0) 1 (100) 1 Mälarsjukhuset, Eskilstuna 29 (30) 30 (31) 21 (21) 18 (18) 98 Nyköpings lasarett 11 (15) 17 (24) 41 (57) 3 (4) 72 Örebro Universitetssjukhus 16 (13) 15 (12) 29 (23) 66 (52) 126 Others/missing 0 (0) 0 (0) 0 (0) 2 (100) 2 West Alingsås lasarett 53 (49) 24 (22) 12 (11) 19 (18) 108 Borås lasarett 77 (51) 34 (22) 11 (7) 30 () 152 Kungälvs sjukhus 23 (39) 10 (17) (34) 6 (10) 59 Kärnsjukhuset Skövde 83 () 16 (12) 33 (24) 6 (4) 138 Lidköping, (Bas)sjukhuset 7 (18) 14 (35) 18 (45) 1 (2) Lundby sjukhus 56 (43) 31 (24) 32 (24) 12 (9) 131 Mariestads sjukhus 0 (0) 0 (0) 1 (100) 0 (0) 1 Sahlgr Univ Sjh/Östra 0 (0) 0 (0) 0 (0) 1 (100) 1 Sahlgrenska Universitetssjukhuset 1 (29) 148 (31) 149 (31) 39 (8) 476 Uddevalla sjukhus (9) 22 (10) 157 (73) 16 (7) 215 Varbergs sjukhus 58 (33) 56 (32) 55 (31) 7 (4) 176 Private practice 102 (45) 59 (26) 55 (24) 9 (4) 225 Others/missing 0 (0) 1 (12) 3 (38) 4 (50) 8 Southeast Höglandssjukhuset (Eksjö-Nässjö lasarett) 0 (0) 2 () 1 () 2 () 5 Kalmar länssjukhus 113 (55) 18 (9) (10) 55 (27) 6 Oskarshamns sjukhus (lasarett) 0 (0) 0 (0) 1 (100) 0 (0) 1 Ryhov, länssjukhuset (Jönköpings lasarett) 86 (36) 92 (39) 52 (22) 6 (3) 236 Universitetssjukhuset i Linköping 50 () 108 (44) 71 (29) 16 (7) 245 Vrinnevisjukhuset i Norrköping 7 (9) 6 (8) 50 (65) 14 (18) 77 Västerviks sjukhus 3 (3) 4 (5) 73 (83) 8 (9) 88 Private practice 1 (50) 0 (0) 1 (50) 0 (0) 2 Others/missing 0 (0) 1 (25) 2 (50) 1 (25) 4 South Blekingesjukhuset Karlskrona 10 (7) 9 (6) 109 (72) 24 (16) 152 Hallands sjukhus - Halmstad (32) 68 (36) 37 () 24 (13) 189 Helsingsborgs lasarett (11) 51 (29) 54 (31) 52 (29) 177 Kristianstad, centralsjukhuset 23 (35) 12 (18) 27 (41) 4 (6) 66 Universitetssjukhuset i Lund 35 () 45 (26) 62 (35) 34 (19) 176 Universitetssjukhuset MAS 194 (30) 255 (39) 118 (18) 79 (12) 646 Växjö lasarett 6 (7) 8 (9) 75 (83) 1 (1) 90 Others/missing 2 (50) 0 (0) 0 (0) 2 (50) 4 Stockholm/Gotland Danderyds sjukhus 7 (6) 34 (28) 46 (38) 34 (28) 121 Huddinge - Karolinska universitetssjukhuset 34 (18) 89 (46) 39 () 32 (16) 194 Karolinska sjukhuset 277 (24) 477 (41) 270 (23) 132 (11) 1156 S:t Görans sjukhus AB 233 (70) 50 (15) (6) 29 (9) 332 Södersjukhuset 5 (5) 22 (23) 49 (52) 18 (19) 94 Visby lasarett 13 (28) 3 (6) 25 (53) 6 (13) 47 Private practice 56 (78) 6 (8) 6 (8) 4 (6) 72 Others/missing 48 (80) 8 (13) 1 (2) 3 (5) SWEDEN Total 21 (30) 85 (28) 37 (27) 1086 (15) 79

42 Table 13. Preoperative nerve sparing intent, by hospital, for low risk category (T1c, Gleason score 6 or less, PSA less than µg/l), Yes, bilateral Yes, unilateral No Missing Total North Sunderby sjukhus 0 (0) 1 (8) 3 (23) 9 (69) 13 Sundsvalls sjukhus 7 (41) 3 (18) 2 (12) 5 (29) 17 Umeå - Norrlands universitetssjukhus 22 (34) 12 (18) 2 (3) 29 (45) 65 Östersunds sjukhus (49) 4 (10) 2 (5) 15 (37) 41 Uppsala/Örebro Akademiska sjukhuset (56) 23 (32) 6 (8) 2 (3) 71 Central sjukhuset i Karlstad 14 () 7 () 12 (34) 2 (6) 35 Centrallasarettet i Västerås 12 (27) 12 (27) 9 () 12 (27) 45 Falu lasarett 2 (7) 11 (38) 3 (10) 13 (45) 29 Gävle sjukhus 4 (18) 5 (23) 2 (9) 11 (50) 22 Mälarsjukhuset, Eskilstuna 14 (41) 11 (32) 4 (12) 5 (15) 34 Nyköpings lasarett 8 (25) 11 (34) 12 (38) 1 (3) 32 Örebro Universitetssjukhus 9 (19) 6 (13) 10 (21) 22 (47) 47 Others/missing 0 (0) 0 (0) 0 (0) 1 (100) 1 West Alingsås lasarett 27 (64) 7 (17) 3 (7) 5 (12) 42 Borås lasarett 36 (61) 13 (22) 0 (0) 10 (17) 59 Kungälvs sjukhus 10 (50) 4 () 3 (15) 3 (15) Kärnsjukhuset Skövde 52 (81) 3 (5) 5 (8) 4 (6) 64 Lidköping, (Bas)sjukhuset 6 (33) 8 (44) 4 (22) 0 (0) 18 Lundby sjukhus 38 (76) 6 (12) 3 (6) 3 (6) 50 Sahlgrenska Universitetssjukhuset 97 (55) 43 (25) 22 (13) 13 (7) 175 Uddevalla sjukhus 15 (13) 14 (12) 75 (65) 11 (10) 115 Varbergs sjukhus 39 (67) 12 (21) 3 (5) 4 (7) 58 Private practice (73) 16 () 4 (5) 2 (2) 82 Others/missing 0 (0) 0 (0) 1 (33) 2 (67) 3 Southeast Höglandssjukhuset (Eksjö-Nässjö lasarett) 0 (0) 1 (50) 0 (0) 1 (50) 2 Kalmar länssjukhus 27 (71) 2 (5) 1 (3) 8 (21) 38 Oskarshamns sjukhus (lasarett) 0 (0) 0 (0) 1 (100) 0 (0) 1 Ryhov, länssjukhuset (Jönköpings lasarett) 46 () 16 (21) 14 (18) 1 (1) 77 Universitetssjukhuset i Linköping 34 (45) 25 (33) 10 (13) 6 (8) 75 Vrinnevisjukhuset i Norrköping 1 () 0 (0) 1 () 3 () 5 Västerviks sjukhus 2 (14) 2 (14) 9 (64) 1 (7) 14 Others/missing 0 (0) 1 (50) 1 (50) 0 (0) 2 South Blekingesjukhuset Karlskrona 5 (10) 5 (10) 34 (69) 5 (10) 49 Hallands sjukhus - Halmstad 27 (48) 15 (27) 8 (14) 6 (11) 56 Helsingsborgs lasarett 6 (27) 5 (23) 5 (23) 6 (27) 22 Kristianstad, centralsjukhuset 11 (55) 4 () 1 (5) 4 () Universitetssjukhuset i Lund 23 (44) 6 (12) 14 (27) 9 (17) 52 Universitetssjukhuset MAS 89 (50) 54 (30) 13 (7) 22 (12) 178 Växjö lasarett 6 (24) 4 (16) 14 (56) 1 (4) 25 Others/missing 2 (50) 0 (0) 0 (0) 2 (50) 4 Stockholm/Gotland Danderyds sjukhus 3 (8) 19 (51) 7 (19) 8 (22) 37 Huddinge - Karolinska universitetssjukhuset 14 (22) 31 (48) 5 (8) 14 (22) 64 Karolinska sjukhuset 170 (35) 189 (39) 76 (16) 53 (11) 488 S:t Görans sjukhus AB 122 (85) 13 (9) 4 (3) 5 (3) 144 Södersjukhuset 3 (10) 11 (35) 10 (32) 7 (23) 31 Visby lasarett 8 (62) 0 (0) 4 (31) 1 (8) 13 Private practice 31 (91) 1 (3) 0 (0) 2 (6) 34 Others/missing 30 (91) 2 (6) 0 (0) 1 (3) 33 SWEDEN Total 1192 (46) 638 (25) 422 (16) 350 (13) Prostatacancer - Nationell kvalitetsrapport, 10

43 Table 14. Postoperative T-stage (pt-stage), by year of diagnosis, pt2 pt3-4 Missing Total Year of diagnosis (67) 628 (28) 115 (5) (69) 769 (28) 87 (3) (67) 7 (30) 77 (3) patients with pt0 are excluded from the table. Prostatacancer - Nationell kvalitetsrapport, 10 43

44 Table 15. Postoperative T-stage (pt-stage), by hospital, pt2 pt3-4 Missing Total North Sunderby sjukhus 17 (52) 9 (27) 7 (21) 33 Sundsvalls sjukhus 24 (80) 4 (13) 2 (7) 30 Umeå - Norrlands universitetssjukhus 81 (53) 55 (36) 18 (12) 154 Östersunds sjukhus 62 (71) 16 (18) 9 (10) 87 Private practice 1 (100) 0 (0) 0 (0) 1 Others/missing 0 (0) 1 (100) 0 (0) 1 Uppsala/Örebro Akademiska sjukhuset 1 (71) 55 (28) 2 (1) 197 Central sjukhuset i Karlstad 94 (67) 44 (31) 2 (1) 1 Centrallasarettet i Västerås 63 (45) 75 (54) 2 (1) 1 Falu lasarett 49 (66) (27) 5 (7) 74 Gävle sjukhus 47 (57) 30 (37) 5 (6) 82 Kullbergska sjukhuset 0 (0) 1 (100) 0 (0) 1 Mälarsjukhuset, Eskilstuna 53 (54) 35 (36) 10 (10) 98 Nyköpings lasarett (56) 32 (44) 0 (0) 72 Örebro Universitetssjukhus 99 (79) 18 (14) 9 (7) 126 Others/missing 0 (0) 1 (50) 1 (50) 2 West Alingsås lasarett 90 (83) 17 (16) 1 (1) 108 Borås lasarett 112 (74) 37 (24) 3 (2) 152 Kungälvs sjukhus 38 (64) (34) 1 (2) 59 Kärnsjukhuset Skövde 86 (63) 49 (36) 1 (1) 136 Lidköping, (Bas)sjukhuset 25 (62) 15 (38) 0 (0) Lundby sjukhus 96 (73) 33 (25) 2 (2) 131 Mariestads sjukhus 0 (0) 1 (100) 0 (0) 1 Sahlgr Univ Sjh/Östra 1 (100) 0 (0) 0 (0) 1 Sahlgrenska Universitetssjukhuset 357 (75) 116 (24) 3 (1) 476 Uddevalla sjukhus 157 (74) 50 (23) 6 (3) 213 Varbergs sjukhus 104 (59) 32 (18) (23) 176 Private practice 165 (74) 51 (23) 8 (4) 224 Others/missing 2 (25) 2 (25) 4 (50) 8 Southeast Höglandssjukhuset (Eksjö-Nässjö lasarett) 4 (80) 0 (0) 1 () 5 Kalmar länssjukhus 110 (54) 88 (43) 7 (3) 5 Oskarshamns sjukhus (lasarett) 1 (100) 0 (0) 0 (0) 1 Ryhov, länssjukhuset (Jönköpings lasarett) 169 (73) (26) 4 (2) 233 Universitetssjukhuset i Linköping 171 (70) 74 (30) 0 (0) 245 Vrinnevisjukhuset i Norrköping 41 (53) 36 (47) 0 (0) 77 Västerviks sjukhus 42 (49) 37 (44) 6 (7) 85 Private practice 1 (50) 1 (50) 0 (0) 2 Others/missing 3 (75) 0 (0) 1 (25) 4 South Blekingesjukhuset Karlskrona 110 (73) 37 (25) 4 (3) 151 Hallands sjukhus - Halmstad 1 (74) 43 (23) 6 (3) 189 Helsingsborgs lasarett 111 (63) 61 (34) 5 (3) 177 Kristianstad, centralsjukhuset 47 (71) 13 () 6 (9) 66 Universitetssjukhuset i Lund 108 (62) 57 (33) 10 (6) 175 Universitetssjukhuset MAS 428 (66) 4 (32) 12 (2) 644 Växjö lasarett 62 (69) 25 (28) 3 (3) 90 Others/missing 1 (25) 0 (0) 3 (75) 4 Stockholm/Gotland Danderyds sjukhus 85 (70) 35 (29) 1 (1) 121 Huddinge - Karolinska universitetssjukhuset 122 (63) 61 (31) 11 (6) 194 Karolinska sjukhuset 782 (68) 341 (30) 32 (3) 1155 S:t Görans sjukhus AB 2 (78) 69 (21) 3 (1) 332 Södersjukhuset 61 (65) 27 (29) 6 (6) 94 Visby lasarett 28 (65) 10 (23) 5 (12) 43 Private practice 50 (71) 12 (17) 8 (11) 70 Others/missing 49 (82) 7 (12) 4 (7) SWEDEN Total 4989 (68) 2117 (29) 279 (4) 7385