Rapid communicationContemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium☆
Section snippets
Patients
Between 1994 and 2000, 5079 men with clinically localized prostate cancer and no neoadjuvant hormonal or radiation therapy underwent radical retropubic prostatectomy (RRP) and a staging pelvic lymphadenectomy at the Johns Hopkins Hospital by 1 of 11 attending surgeons.
Inclusion criteria
Men enrolled in this cohort had (a) a preoperative monoclonal serum PSA level on an ambulatory basis before RRP and at least 4 weeks after the prostate biopsy, (b) a biopsy histologic grade (Gleason score), and (c) a clinical
Participant demographics
In the study, 5079 men, average age 57.9 ± 6 years (range 42 to 74) who fit the enrollment criteria, were consecutively enrolled. Ninety percent of the men were white and 6% African American. Within the PSA groups, 7%, 10%, 27%, 35%, and 21% were within the 0 to 2.5, 2.6 to 4.0, 4.1 to 6.0, 6.1 to 10, and more than 10.0 ng/mL groups, respectively. Biopsy Gleason grades (sum) demonstrated 0.6%, 79%, 13%, 4.4%, and 3% with a Gleason score of 2 to 4, 5 to 6, 3 + 4 = 7, 4 + 3 = 7, and 8 to 10,
Comment
The presentation of men with localized prostate cancer during the past 10 to 20 years has changed greatly. More men are presenting with well to moderately differentiated tumors (Gleason 4 to 6), PSA levels less than 10.0 ng/mL, and nonpalpable (Stage T1c) disease. This dramatic change in presentation, which may be due to PSA and better screening strategies, has nonetheless caused a major stage migration for prostate cancer, with nearly 60% of newly diagnosed cases presenting with localized or
Conclusions
We have updated our nomograms for predicting pathologic stage for prostate cancer with a more contemporary cohort of men treated between 1994 and 2000. The new nomograms combine PSA, biopsy Gleason score, and clinical stage with improved substratification of both Gleason and PSA groups. The new “Partin Tables” may help us counsel our patients regarding their likelihood of having various pathologic stages and aid in important decision making.
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This study was supported by Prostate SPORE grant CA 58236 and NCI Early Detection Research Network (EDRN) grant UO1 CA 86323.