Pretreatment tables predicting pathologic stage of locally advanced prostate cancer

Steven Joniau, Martin Spahn, Alberto Briganti, Giorgio Gandaglia, Bertrand Tombal, Lorenzo Tosco, Giansilvio Marchioro, Chao Yu Hsu, Jochen Walz, Burkhard Kneitz, Pia Bader, Detlef Frohneberg, Alessandro Tizzani, Markus Graefen, Paul Van Cangh, Robert Jeffrey Karnes, Francesco Montorsi, Hein Van Poppel, Paolo Gontero

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa. Objective To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice. Design, setting, and participants This was a multicenter retrospective cohort study including 759 consecutive patients with cT3a PCa treated with RP between 1987 and 2010. Intervention Retropubic RP and pelvic lymphadenectomy. Outcome measurements and statistical analysis Patients were divided into pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (GS) subgroups. These parameters were used to construct tables predicting pathologic outcome and the presence of positive lymph nodes (LNs) after RP for cT3a PCa using ordinal logistic regression. Results and limitations In the model predicting pathologic outcome, the main effects of biopsy GS and pretreatment PSA were significant. A higher GS and/or higher PSA level was associated with a more unfavorable pathologic outcome. The validation procedure, using a repeated split-sample method, showed good predictive ability. Regression analysis also showed an increasing probability of positive LNs with increasing PSA levels and/or higher GS. Limitations of the study are the retrospective design and the long study period. Conclusions These novel tables predict pathologic stage after RP for patients with cT3a PCa based on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa. Patient summary Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment.

Original languageEnglish (US)
Pages (from-to)319-325
Number of pages7
JournalEuropean Urology
Volume67
Issue number2
DOIs
StatePublished - Feb 1 2015

Fingerprint

Prostatic Neoplasms
Neoplasm Grading
Prostate-Specific Antigen
Prostatectomy
Biopsy
Retrospective Studies
Lymph Nodes
Combined Modality Therapy
Aptitude
Lymph Node Excision
Decision Making
Cohort Studies
Logistic Models
Regression Analysis
Physicians

Keywords

  • Locally advanced prostate cancer
  • Pretreatment tables
  • Prostate cancer
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Joniau, S., Spahn, M., Briganti, A., Gandaglia, G., Tombal, B., Tosco, L., ... Gontero, P. (2015). Pretreatment tables predicting pathologic stage of locally advanced prostate cancer. European Urology, 67(2), 319-325. https://doi.org/10.1016/j.eururo.2014.03.013

Pretreatment tables predicting pathologic stage of locally advanced prostate cancer. / Joniau, Steven; Spahn, Martin; Briganti, Alberto; Gandaglia, Giorgio; Tombal, Bertrand; Tosco, Lorenzo; Marchioro, Giansilvio; Hsu, Chao Yu; Walz, Jochen; Kneitz, Burkhard; Bader, Pia; Frohneberg, Detlef; Tizzani, Alessandro; Graefen, Markus; Van Cangh, Paul; Karnes, Robert Jeffrey; Montorsi, Francesco; Van Poppel, Hein; Gontero, Paolo.

In: European Urology, Vol. 67, No. 2, 01.02.2015, p. 319-325.

Research output: Contribution to journalArticle

Joniau, S, Spahn, M, Briganti, A, Gandaglia, G, Tombal, B, Tosco, L, Marchioro, G, Hsu, CY, Walz, J, Kneitz, B, Bader, P, Frohneberg, D, Tizzani, A, Graefen, M, Van Cangh, P, Karnes, RJ, Montorsi, F, Van Poppel, H & Gontero, P 2015, 'Pretreatment tables predicting pathologic stage of locally advanced prostate cancer', European Urology, vol. 67, no. 2, pp. 319-325. https://doi.org/10.1016/j.eururo.2014.03.013
Joniau S, Spahn M, Briganti A, Gandaglia G, Tombal B, Tosco L et al. Pretreatment tables predicting pathologic stage of locally advanced prostate cancer. European Urology. 2015 Feb 1;67(2):319-325. https://doi.org/10.1016/j.eururo.2014.03.013
Joniau, Steven ; Spahn, Martin ; Briganti, Alberto ; Gandaglia, Giorgio ; Tombal, Bertrand ; Tosco, Lorenzo ; Marchioro, Giansilvio ; Hsu, Chao Yu ; Walz, Jochen ; Kneitz, Burkhard ; Bader, Pia ; Frohneberg, Detlef ; Tizzani, Alessandro ; Graefen, Markus ; Van Cangh, Paul ; Karnes, Robert Jeffrey ; Montorsi, Francesco ; Van Poppel, Hein ; Gontero, Paolo. / Pretreatment tables predicting pathologic stage of locally advanced prostate cancer. In: European Urology. 2015 ; Vol. 67, No. 2. pp. 319-325.
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abstract = "Background Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa. Objective To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice. Design, setting, and participants This was a multicenter retrospective cohort study including 759 consecutive patients with cT3a PCa treated with RP between 1987 and 2010. Intervention Retropubic RP and pelvic lymphadenectomy. Outcome measurements and statistical analysis Patients were divided into pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (GS) subgroups. These parameters were used to construct tables predicting pathologic outcome and the presence of positive lymph nodes (LNs) after RP for cT3a PCa using ordinal logistic regression. Results and limitations In the model predicting pathologic outcome, the main effects of biopsy GS and pretreatment PSA were significant. A higher GS and/or higher PSA level was associated with a more unfavorable pathologic outcome. The validation procedure, using a repeated split-sample method, showed good predictive ability. Regression analysis also showed an increasing probability of positive LNs with increasing PSA levels and/or higher GS. Limitations of the study are the retrospective design and the long study period. Conclusions These novel tables predict pathologic stage after RP for patients with cT3a PCa based on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa. Patient summary Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment.",
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AU - Spahn, Martin

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AU - Tosco, Lorenzo

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AU - Hsu, Chao Yu

AU - Walz, Jochen

AU - Kneitz, Burkhard

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AU - Tizzani, Alessandro

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AU - Van Cangh, Paul

AU - Karnes, Robert Jeffrey

AU - Montorsi, Francesco

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N2 - Background Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa. Objective To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice. Design, setting, and participants This was a multicenter retrospective cohort study including 759 consecutive patients with cT3a PCa treated with RP between 1987 and 2010. Intervention Retropubic RP and pelvic lymphadenectomy. Outcome measurements and statistical analysis Patients were divided into pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (GS) subgroups. These parameters were used to construct tables predicting pathologic outcome and the presence of positive lymph nodes (LNs) after RP for cT3a PCa using ordinal logistic regression. Results and limitations In the model predicting pathologic outcome, the main effects of biopsy GS and pretreatment PSA were significant. A higher GS and/or higher PSA level was associated with a more unfavorable pathologic outcome. The validation procedure, using a repeated split-sample method, showed good predictive ability. Regression analysis also showed an increasing probability of positive LNs with increasing PSA levels and/or higher GS. Limitations of the study are the retrospective design and the long study period. Conclusions These novel tables predict pathologic stage after RP for patients with cT3a PCa based on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa. Patient summary Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment.

AB - Background Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa. Objective To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice. Design, setting, and participants This was a multicenter retrospective cohort study including 759 consecutive patients with cT3a PCa treated with RP between 1987 and 2010. Intervention Retropubic RP and pelvic lymphadenectomy. Outcome measurements and statistical analysis Patients were divided into pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (GS) subgroups. These parameters were used to construct tables predicting pathologic outcome and the presence of positive lymph nodes (LNs) after RP for cT3a PCa using ordinal logistic regression. Results and limitations In the model predicting pathologic outcome, the main effects of biopsy GS and pretreatment PSA were significant. A higher GS and/or higher PSA level was associated with a more unfavorable pathologic outcome. The validation procedure, using a repeated split-sample method, showed good predictive ability. Regression analysis also showed an increasing probability of positive LNs with increasing PSA levels and/or higher GS. Limitations of the study are the retrospective design and the long study period. Conclusions These novel tables predict pathologic stage after RP for patients with cT3a PCa based on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa. Patient summary Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment.

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KW - Prostate cancer

KW - Radical prostatectomy

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