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Updated Nomogram to Predict Pathologic Stage of Prostate Cancer Given Prostate-Specific Antigen Level, Clinical Stage, and Biopsy Gleason Score (Partin Tables) Based on Cases from 2000 to 2005 - 09/08/11

Doi : 10.1016/j.urology.2007.03.042 
Danil V. Makarov a, , Bruce J. Trock a, Elizabeth B. Humphreys a, Leslie A. Mangold a, Patrick C. Walsh a, Jonathan I. Epstein a, b, Alan W. Partin a
a Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 
b Department of Pathology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 

Reprint requests: Danil V. Makarov, M.D., Department of Urology, Johns Hopkins University School of Medicine, Marburg 145, 600 North Wolfe Street, Baltimore, MD 21287-2101.

Resumen

Objectives

To update the 2001 “Partin tables” with a contemporary patient cohort and revised variable categorization, correcting for the effects of stage migration.

Methods

We analyzed 5730 men treated with prostatectomy (without neoadjuvant therapy) between 2000 and 2005 at the Johns Hopkins Hospital. Average age was 57 years. Multivariable logistic regression was used to estimate the probability of organ-confined disease, extraprostatic extension, seminal vesicle involvement, or lymph node involvement. Predictor variables included preoperative prostate-specific antigen (PSA) level (0 to 2.5, 2.6 to 4.0, 4.1 to 6.0, 6.1 to 10.0, and greater than 10.0 ng/mL), clinical stage (T1c, T2a, and T2b/T2c), and biopsy Gleason score (5 to 6, 3 + 4 = 7, 4 + 3 = 7, or 8 to 10). Bootstrap resampling was used to generate 95% confidence intervals for predicted probabilities.

Results

Seventy-seven percent of patients had T1c, 76% had Gleason score 5 to 6, 80% had a PSA level between 2.5 and 10.0 ng/mL, and 73% had organ-confined disease. Nomograms were developed for the predicted probability of pathologically organ-confined disease, extraprostatic extension, seminal vesicle invasion, or lymph node involvement. The risk of non-organ-confined disease increased with increases in any individual prognostic factor. The dramatic decrease in clinical stage T2c compared with the patient series used in the previous models resulted in T2b and T2c being combined as a single predictor in the nomogram.

Conclusions

These updated “Partin tables” were generated to reflect trends in presentation and pathologic stage for men diagnosed with clinically localized prostate cancer at our institution. Clinicians and patients can use these nomograms to help make important decisions regarding management of prostate cancer.

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Esquema


 This study was supported by National Institute of Health/National Cancer Institute (NIH/NCI) SPORE grant P50CA58236, The Prostate Cancer Foundation, and Early Detection Research Network/NIH/NCI grant U01-CA86323.


© 2007  Elsevier Inc. Reservados todos los derechos.
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Vol 69 - N° 6

P. 1095-1101 - juin 2007 Regresar al número
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