Analysis of clinical stage T2 prostate cancer: do current subclassifications represent an improvement?
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Analysis of clinical stage T2 prostate cancer: do current subclassifications represent an improvement? / Cagiannos, Ilias; Graefen, Markus; Karakiewicz, Pierre I; Ohori, Makato; Eastham, James A; Rabbani, Farhang; Fair, William; Wheeler, Thomas M; Hammerer, Peter G; Haese, Alexander; Erbersdobler, Andreas; Huland, Hartwig; Scardino, Peter T; Kattan, Michael W.
In: J CLIN ONCOL, Vol. 20, No. 8, 8, 2002, p. 2025-2030.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Analysis of clinical stage T2 prostate cancer: do current subclassifications represent an improvement?
AU - Cagiannos, Ilias
AU - Graefen, Markus
AU - Karakiewicz, Pierre I
AU - Ohori, Makato
AU - Eastham, James A
AU - Rabbani, Farhang
AU - Fair, William
AU - Wheeler, Thomas M
AU - Hammerer, Peter G
AU - Haese, Alexander
AU - Erbersdobler, Andreas
AU - Huland, Hartwig
AU - Scardino, Peter T
AU - Kattan, Michael W
PY - 2002
Y1 - 2002
N2 - PURPOSE: The purpose of this study was to determine whether the extent of palpable cancer within the prostate predicts outcome after radical prostatectomy. PATIENTS AND METHODS: We combined prospectively collected data on 1,755 consecutive clinical stage T2 patients treated with radical prostatectomy alone at four institutions. According to the 1992 American Joint Committee on Cancer tumor-node-metastasis system, 645 (37%) were T2a, 758 (43%) were T2b, and 352 (20%) were T2c. Kaplan-Meier and proportional hazards regression analyses were performed on the 1992 and 1997 T2 subclassifications. After controlling for the effects of prostate-specific antigen (PSA) and biopsy Gleason sum, the two staging systems were compared for their ability to predict recurrence-free survival (RFS). Adjusted RFS curves were constructed using the corrected group prognosis method. RESULTS: Follow-up ranged from 1 to 166 months (median, 26 months). Cancer recurred in 417 (24%) of the T2 patients. The 1992 (P =.005) but not the 1997 (P =.100) T2 subclassification predicted outcome after controlling for PSA and Gleason sum. After covariate adjustment, RFS was 7% higher at 5 years in the 1992 T2a subcategory relative to the T2b subcategory. CONCLUSION: The 1992 American Joint Committee on Cancer system is superior to the 1997 system, and the former adds prognostic information to a model containing pretreatment PSA and Gleason sum. These results suggest that 1992 T2 subclassification derived from palpable findings improves prognostication over the 1997 subclassification.
AB - PURPOSE: The purpose of this study was to determine whether the extent of palpable cancer within the prostate predicts outcome after radical prostatectomy. PATIENTS AND METHODS: We combined prospectively collected data on 1,755 consecutive clinical stage T2 patients treated with radical prostatectomy alone at four institutions. According to the 1992 American Joint Committee on Cancer tumor-node-metastasis system, 645 (37%) were T2a, 758 (43%) were T2b, and 352 (20%) were T2c. Kaplan-Meier and proportional hazards regression analyses were performed on the 1992 and 1997 T2 subclassifications. After controlling for the effects of prostate-specific antigen (PSA) and biopsy Gleason sum, the two staging systems were compared for their ability to predict recurrence-free survival (RFS). Adjusted RFS curves were constructed using the corrected group prognosis method. RESULTS: Follow-up ranged from 1 to 166 months (median, 26 months). Cancer recurred in 417 (24%) of the T2 patients. The 1992 (P =.005) but not the 1997 (P =.100) T2 subclassification predicted outcome after controlling for PSA and Gleason sum. After covariate adjustment, RFS was 7% higher at 5 years in the 1992 T2a subcategory relative to the T2b subcategory. CONCLUSION: The 1992 American Joint Committee on Cancer system is superior to the 1997 system, and the former adds prognostic information to a model containing pretreatment PSA and Gleason sum. These results suggest that 1992 T2 subclassification derived from palpable findings improves prognostication over the 1997 subclassification.
M3 - SCORING: Zeitschriftenaufsatz
VL - 20
SP - 2025
EP - 2030
JO - J CLIN ONCOL
JF - J CLIN ONCOL
SN - 0732-183X
IS - 8
M1 - 8
ER -