Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium
Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium
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DOI：
10.1016/s0090-4295(01)01441-8
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发表时间：
2001-12-01
期刊：
影响因子：
2.1
通讯作者：
Pearson, JD
中科院分区：
文献类型：
--
作者：
Partin, AW;Mangold, LA;Pearson, JD
目标.我们先前提出了列线图结合术前血清前列腺特异性抗原（PSA），临床（TNM）阶段，活检Gleason评分，以提供各种最终病理分期的可能性在根治性耻骨后前列腺切除术。原始列线图的数据是从1982年至1996年接受治疗的男性中收集的。在过去的10年中，出现的阶段已经发生了变化，更多的男性出现T1 c期，Gleason评分为5至6分，血清PSA水平低于10.0 ng/mL。在这项工作中，我们更新了“Partin表”，自1994年以来接受治疗的男性更现代的队列，并修订了PSA和Gleason分类。采用多项对数线性回归分析，根据术前PSA（分层为0 - 2.5、2.6 - 4.0、4.1 - 6.0、6.1 - 10.0和大于10 ng/mL），临床（AJCC-TNM，1992年）阶段（T1 c、T2 a、T2 b或T2 c），活检Gleason评分分层为2 - 4、5 - 6、3 + 4 = 7、4 + 3 = 7，或1994年至2000年在约翰霍普金斯医院接受直肠癌切除术（无新辅助治疗）的5079名男性中有8至10人。平均年龄58岁。在该队列中，超过60%的患者患有T1 c，超过75%的患者Gleason评分为6，超过70%的患者PSA大于2.5且小于10.0 ng/mL，超过60%的患者患有器官局限性疾病。从1000次自助分析中得出了稳健估计似然性和95%置信区间的列线图。各组间器官局限性疾病的概率均有所改善，Gleason评分和PSA水平的进一步分层可更好地区分个体患者。这些更新的“Partin表”是为了反映我们机构新诊断为临床局限性前列腺癌的男性的表现和病理分期趋势。临床医生可以使用这些列线图来咨询个别患者，并帮助他们做出有关疾病的重要决定。泌尿学58：843-848，2001年。(C)2001年，Elsevier Science Inc.
Objectives. We previously presented nomograms combining preoperative serum prostate-specific antigen (PSA), clinical (TNM) stage, and biopsy Gleason score to provide the likelihood of various final pathologic stages at radical retropubic prostatectomy. The data for the original nomograms were collected from men treated between 1982 and 1996. During the past 10 years, the stage at presentation has shifted, with more men presenting with Stage T1c, Gleason score 5 to 6, and serum PSA levels less than 10.0 ng/mL. In this work, we update the "Partin Tables" with a more contemporary cohort of men treated since 1994 and with revised PSA and Gleason categories.Methods. Multinomial log-linear regression analysis was used to estimate the likelihood of organ-confined disease, extraprostatic extension, seminal vesicle or lymph nodal status from the preoperative PSA stratified as 0 to 2.5, 2.6 to 4.0, 4.1 to 6.0, 6.1 to 10.0, and greater than 10 ng/mL, clinical (AJCC-TNM, 1992) stage (T1c, T2a, T2b, or T2c), and biopsy Gleason score stratified as 2 to 4, 5 to 6, 3 + 4 = 7, 4 + 3 = 7, or 8 to 10 among 5079 men treated with prostatectomy (without neoadjuvant therapy) between 1994 and 2000 at Johns Hopkins Hospital. The average age was 58 years.Results. In this cohort, more than 60% had T1c, more than 75% had Gleason score of 6, more than 70% had PSA greater than 2.5 and less than 10.0 ng/mL, and more than 60% had organ-confined disease. Nomograms of the robust estimated likelihoods and 95% confidence intervals were developed from 1000 bootstrap analyses. The probability of organ-confined disease improved across the groups, and further stratification of the Gleason score and PSA level allowed better differentiation of individual patients.Conclusions. These updated "Partin Tables" were generated to reflect the trends in presentation and pathologic stage for men newly diagnosed with clinically localized prostate cancer at our institution. Clinicians can use these nomograms to counsel individual patients and help them make important decisions regarding their disease. UROLOGY 58: 843-848, 2001. (C) 2001, Elsevier Science Inc.