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Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium - 03/09/11

Doi : 10.1016/S0090-4295(01)01441-8 
Alan W Partin , a, Leslie A Mangold a, Dana M Lamm a, Patrick C Walsh a, Jonathan I Epstein a, Jay D Pearson b
a James Buchanan Brady Urological Institute and Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA 
b Merck Research Laboratories, Rahway, New Jersey, USA 

*Reprint requests: Alan W. Partin, M.D., Ph.D., Brady Urological Institute, Johns Hopkins Hospital, 600 North Wolfe Street, Marburg 205A, Baltimore, MD 21287-2101 USA

Abstract

Objectives. We previously presented nomograms combining preoperative serum prostate-specific antigen (PSA), clinical (TNM) stage, and biopsy Gleason score to provide the likelihood of various final pathologic stages at radical retropubic prostatectomy. The data for the original nomograms were collected from men treated between 1982 and 1996. During the past 10 years, the stage at presentation has shifted, with more men presenting with Stage T1c, Gleason score 5 to 6, and serum PSA levels less than 10.0 ng/mL. In this work, we update the “Partin Tables” with a more contemporary cohort of men treated since 1994 and with revised PSA and Gleason categories.

Methods. Multinomial log-linear regression analysis was used to estimate the likelihood of organ-confined disease, extraprostatic extension, seminal vesicle or lymph nodal status from the preoperative PSA stratified as 0 to 2.5, 2.6 to 4.0, 4.1 to 6.0, 6.1 to 10.0, and greater than 10 ng/mL, clinical (AJCC-TNM, 1992) stage (T1c, T2a, T2b, or T2c), and biopsy Gleason score stratified as 2 to 4, 5 to 6, 3 + 4 = 7, 4 + 3 = 7, or 8 to 10 among 5079 men treated with prostatectomy (without neoadjuvant therapy) between 1994 and 2000 at Johns Hopkins Hospital. The average age was 58 years.

Results. In this cohort, more than 60% had T1c, more than 75% had Gleason score of 6, more than 70% had PSA greater than 2.5 and less than 10.0 ng/mL, and more than 60% had organ-confined disease. Nomograms of the robust estimated likelihoods and 95% confidence intervals were developed from 1000 bootstrap analyses. The probability of organ-confined disease improved across the groups, and further stratification of the Gleason score and PSA level allowed better differentiation of individual patients.

Conclusions. These updated “Partin Tables” were generated to reflect the trends in presentation and pathologic stage for men newly diagnosed with clinically localized prostate cancer at our institution. Clinicians can use these nomograms to counsel individual patients and help them make important decisions regarding their disease.

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Plan


 This study was supported by Prostate SPORE grant CA 58236 and NCI Early Detection Research Network (EDRN) grant UO1 CA 86323.


© 2001  Elsevier Science Inc. Tous droits réservés.
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Vol 58 - N° 6

P. 843-848 - décembre 2001 Retour au numéro
Article précédent Article précédent
  • Progress in prostate cancer chemoprevention: modulators of promotion and progression
  • Ronald Lieberman, Carlos Bermejo, Hideyuki Akaza, Peter Greenwald, William Fair, Ian Thompson
| Article suivant Article suivant
  • Is a 1-cm margin necessary during nephron-sparing surgery for renal cell carcinoma?
  • Natania Y Piper, Jay T Bishoff, Christopher Magee, Jason M Haffron, Robert C Flanigan, Annemieke Mintiens, Hein P Van Poppel, Ian M Thompson, William J Harmon

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