Abstract
Purpose/Objectives: The patients most suitable for a radical prostatectomy (RP) are those with organ confined disease. At least(1(3)) of patients with clinically staged organ confined disease will be found to have extra capsular extension (ECE) following RP. The purpose of this study is to assess the predictive value of an equation for predicting the risk of ECE based on the pre-treatment prostatic specific antigen (PSA) and Gleason score (GS) in patients with clinical stage T1/T2 prostate cancer. Materials and Methods: Two hundred and twenty-two patients who underwent RP at either the San Francisco VAMC or UCSF between 1988 and 1994 were eligible for this analysis. Patients were considered eligible if the pathological stage, pre-operative PSA and GS were available. Among these patients the median pre-operative PSA was 9 ng/ml (range 0 - 195 ng/ml), and the median pre-operative GS was 6 (range 2-10). The empirically derived equations tested were [1.5 x PSA + (GS - 3) x 10] (Roach, J. Urol., 150: 1923-1924, 1993) as well as a recent modification of this equation of [PSA + (GS - 3.5) x 10]. For these equations, the range of calculated risk was limited to 0 - 100%. Results: The results of using
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Citation Formats
Chen, Anita, Roach, Mack, Diaz, Aidnag, Marquez, Carol, Chinn, Dan, Coleman, Lori, Presti, Joseph, and Carroll, Peter.
Using pre-treatment PSA and Gleason score to predict for extra capsular extension among patients with clinically staged organ confined prostate cancer.
United States: N. p.,
1995.
Web.
doi:10.1016/0360-3016(95)97845-R.
Chen, Anita, Roach, Mack, Diaz, Aidnag, Marquez, Carol, Chinn, Dan, Coleman, Lori, Presti, Joseph, & Carroll, Peter.
Using pre-treatment PSA and Gleason score to predict for extra capsular extension among patients with clinically staged organ confined prostate cancer.
United States.
https://doi.org/10.1016/0360-3016(95)97845-R
Chen, Anita, Roach, Mack, Diaz, Aidnag, Marquez, Carol, Chinn, Dan, Coleman, Lori, Presti, Joseph, and Carroll, Peter.
1995.
"Using pre-treatment PSA and Gleason score to predict for extra capsular extension among patients with clinically staged organ confined prostate cancer."
United States.
https://doi.org/10.1016/0360-3016(95)97845-R.
@misc{etde_20420699,
title = {Using pre-treatment PSA and Gleason score to predict for extra capsular extension among patients with clinically staged organ confined prostate cancer}
author = {Chen, Anita, Roach, Mack, Diaz, Aidnag, Marquez, Carol, Chinn, Dan, Coleman, Lori, Presti, Joseph, and Carroll, Peter}
abstractNote = {Purpose/Objectives: The patients most suitable for a radical prostatectomy (RP) are those with organ confined disease. At least(1(3)) of patients with clinically staged organ confined disease will be found to have extra capsular extension (ECE) following RP. The purpose of this study is to assess the predictive value of an equation for predicting the risk of ECE based on the pre-treatment prostatic specific antigen (PSA) and Gleason score (GS) in patients with clinical stage T1/T2 prostate cancer. Materials and Methods: Two hundred and twenty-two patients who underwent RP at either the San Francisco VAMC or UCSF between 1988 and 1994 were eligible for this analysis. Patients were considered eligible if the pathological stage, pre-operative PSA and GS were available. Among these patients the median pre-operative PSA was 9 ng/ml (range 0 - 195 ng/ml), and the median pre-operative GS was 6 (range 2-10). The empirically derived equations tested were [1.5 x PSA + (GS - 3) x 10] (Roach, J. Urol., 150: 1923-1924, 1993) as well as a recent modification of this equation of [PSA + (GS - 3.5) x 10]. For these equations, the range of calculated risk was limited to 0 - 100%. Results: The results of using these two equations are shown graphically. Using the modified equation, with a calculated risk (CR) of {<=}25% and an average calculated risk (ACR) of 15.4%, the observed incidence (OI) of ECE was 17.2%. Among the patients with a CR of 26 to 50% and an ACR of 36.1%, the OI of ECE was 38.4%. Among the patients with a CR of 51 to 75% and an ACR of 60.4%, the OI of ECE was 62.7%. Finally, among the patients with a CR of 76 to 100% and an ACR of 77.3%, the OI of ECE was 85.7%. Transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) reports were available in 72 patients. Correlation with TRUS demonstrated a sensitivity and specificity of 52.4% and 56.1% respectively. Correlation with MRI showed a sensitivity of 57.9% and a specificity of 45.5%. The use of either MRI or TRUS in predicting advanced localized disease had a sensitivity of 63.6% and a specificity of 44%. Conclusion: The original empirically derived equation tends to overestimate the risk of ECE by {approx} 9.0% (range 5.2-16.0%), while the modified equation appears to underestimate the risk of ECE by {approx}2.6% (range 1.8-8.5%). An improved ability to predict for ECE would allow for better patient counselling in the pre-operative setting, since it may allow for more accurate comparisons to be made of the efficacy of surgery compared to radiation. Patients with a high risk for ECE should be considered candidates for experimental therapy, such as neoadjuvant total androgen suppression, or be prepared to receive adjuvant radiotherapy following their surgery.}
doi = {10.1016/0360-3016(95)97845-R}
journal = []
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}
title = {Using pre-treatment PSA and Gleason score to predict for extra capsular extension among patients with clinically staged organ confined prostate cancer}
author = {Chen, Anita, Roach, Mack, Diaz, Aidnag, Marquez, Carol, Chinn, Dan, Coleman, Lori, Presti, Joseph, and Carroll, Peter}
abstractNote = {Purpose/Objectives: The patients most suitable for a radical prostatectomy (RP) are those with organ confined disease. At least(1(3)) of patients with clinically staged organ confined disease will be found to have extra capsular extension (ECE) following RP. The purpose of this study is to assess the predictive value of an equation for predicting the risk of ECE based on the pre-treatment prostatic specific antigen (PSA) and Gleason score (GS) in patients with clinical stage T1/T2 prostate cancer. Materials and Methods: Two hundred and twenty-two patients who underwent RP at either the San Francisco VAMC or UCSF between 1988 and 1994 were eligible for this analysis. Patients were considered eligible if the pathological stage, pre-operative PSA and GS were available. Among these patients the median pre-operative PSA was 9 ng/ml (range 0 - 195 ng/ml), and the median pre-operative GS was 6 (range 2-10). The empirically derived equations tested were [1.5 x PSA + (GS - 3) x 10] (Roach, J. Urol., 150: 1923-1924, 1993) as well as a recent modification of this equation of [PSA + (GS - 3.5) x 10]. For these equations, the range of calculated risk was limited to 0 - 100%. Results: The results of using these two equations are shown graphically. Using the modified equation, with a calculated risk (CR) of {<=}25% and an average calculated risk (ACR) of 15.4%, the observed incidence (OI) of ECE was 17.2%. Among the patients with a CR of 26 to 50% and an ACR of 36.1%, the OI of ECE was 38.4%. Among the patients with a CR of 51 to 75% and an ACR of 60.4%, the OI of ECE was 62.7%. Finally, among the patients with a CR of 76 to 100% and an ACR of 77.3%, the OI of ECE was 85.7%. Transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) reports were available in 72 patients. Correlation with TRUS demonstrated a sensitivity and specificity of 52.4% and 56.1% respectively. Correlation with MRI showed a sensitivity of 57.9% and a specificity of 45.5%. The use of either MRI or TRUS in predicting advanced localized disease had a sensitivity of 63.6% and a specificity of 44%. Conclusion: The original empirically derived equation tends to overestimate the risk of ECE by {approx} 9.0% (range 5.2-16.0%), while the modified equation appears to underestimate the risk of ECE by {approx}2.6% (range 1.8-8.5%). An improved ability to predict for ECE would allow for better patient counselling in the pre-operative setting, since it may allow for more accurate comparisons to be made of the efficacy of surgery compared to radiation. Patients with a high risk for ECE should be considered candidates for experimental therapy, such as neoadjuvant total androgen suppression, or be prepared to receive adjuvant radiotherapy following their surgery.}
doi = {10.1016/0360-3016(95)97845-R}
journal = []
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}