Commentary RE: Contemporary Update of Prostate Cancer Staging Nomograms (Partin Tables) for the New Millennium and 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

Objectives: To construct new prostate cancer staging lookup tables based on a dataset collated by the British Association of Urological Surgeons (BAUS) and to validate them and compare their predictive power with Partin tables. Patients and methods: Complete data on 1701 patients was collated between 1999 and 2008 across 57 UK centres. Lookup tables were created for prediction of pathological stage (PS) using PSA level, biopsy Gleason score (GS) and clinical stage, replicating Partin's original approach. Tables were generated using logistic regression (LR) and bootstrap resampling methods and were internally validated and externally validated using concordance indices (CI) and area under the receiver operating characteristic curve (AUROC) respectively. Results: The CI and AUROC analyses indicate that Partin tables performed poorly on UK data in comparison with US data. The UK prostate cancer tables performed better than Partin tables but the predictive power of all models was relatively poor. Conclusion: The study shows that the predictive power of Partin tables is reduced when applied to the UK population. Models generated using LR methodology have fundamental limitations, and we suggest alternative modelling methods such as Bayesian networks.

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Combination of Prostate-Specific Antigen, Clinical Stage, and Gleason Score to Predict Pathological Stage of Localized Prostate Cancer

JAMA ◽

10.1001/jama.1997.03540420041027 ◽

1997 ◽

Vol 277 (18) ◽

pp. 1445 ◽

Cited By ~ 941

Author(s):

Alan W. Partin

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Gleason Score ◽

Clinical Stage ◽

Specific Antigen ◽

Localized Prostate Cancer ◽

Pathological Stage

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Pretreatment Nomogram for Prostate-Specific Antigen Recurrence After Radical Prostatectomy or External-Beam Radiation Therapy for Clinically Localized Prostate Cancer

Journal of Clinical Oncology ◽

10.1200/jco.1999.17.1.168 ◽

1999 ◽

Vol 17 (1) ◽

pp. 168-168 ◽

Cited By ~ 280

Author(s):

Anthony V. D'Amico ◽

Richard Whittington ◽

S. Bruce Malkowicz ◽

Julie Fondurulia ◽

Ming-Hui Chen ◽

...

Keyword(s):

Prostate Cancer ◽

Gleason Score ◽

Cox Regression ◽

Clinical Stage ◽

Specific Antigen ◽

External Beam Radiation Therapy ◽

External Beam Radiation ◽

Beam Radiation ◽

Psa Failure ◽

Biopsy Gleason Score

PURPOSE: To present nomograms providing estimates of prostate-specific antigen (PSA) failure–free survival after radical prostatectomy (RP) or external-beam radiation therapy (RT) for men diagnosed during the PSA era with clinically localized disease. PATIENTS AND METHODS: A Cox regression multivariable analysis was used to determine the prognostic significance of the pretreatment PSA level, 1992 American Joint Committee on Cancer (AJCC) clinical stage, and biopsy Gleason score in predicting the time to posttherapy PSA failure in 1,654 men with T1c,2 prostate cancer managed with either RP or RT. RESULTS: Pretherapy PSA, AJCC clinical stage, and biopsy Gleason score were independent predictors (P < .0001) of time to posttherapy PSA failure in patients managed with either RP or RT. Two-year PSA failure rates derived from the Cox regression model and bootstrap estimates of the 95% confidence intervals are presented in the format of a nomogram stratified by the pretreatment PSA, AJCC clinical stage, biopsy Gleason score, and local treatment modality. CONCLUSION: Men at high risk (> 50%) for early (≤ 2 years) PSA failure could be identified on the basis of the type of local therapy received and the clinical information obtained as part of the routine work-up for localized prostate cancer. Selection of these men for trials evaluating adjuvant systemic and improved local therapies may be justified.

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