Prediction of pathological stage based on clinical stage, serum prostate-specific antigen, and biopsy Gleason score: Partin Tables in the contemporary era
Prediction of pathological stage based on clinical stage, serum prostate-specific antigen, and biopsy Gleason score: Partin Tables in the contemporary era
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DOI：
10.1111/bju.13573
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发表时间：
2017-05-01
影响因子：
4.5
通讯作者：
Trock, Bruce J.
中科院分区：
文献类型：
--
作者：
Tosoian, Jeffrey J.;Chappidi, Meera;Trock, Bruce J.
目的更新Partin表预测的病理分期在当代设置和研究的趋势，在过去的三十年根治性前列腺切除术（RP）治疗的患者在过去的three decades.Patients and MethodsFrom 2010年1月至2015年10月，4459名男性符合纳入标准进行RP和盆腔淋巴结切除术的组织学证实的前列腺癌在约翰霍普金斯医院。术前临床分期、血清前列腺特异性抗原（PSA）水平和活检Gleason评分（i. e.预后等级组）用于多分类逻辑回归模型以预测病理结果的概率，所述病理结果分类为：器官局限性（OC）、前列腺外扩展（EPE）、精囊受累（SV+）或淋巴结受累（LN+）。自1983年以来，RP治疗的男性术前的特点和病理结果进行了收集和临床病理trends.ResultsThe中位（范围）年龄在手术是60（34-77）岁，中位（范围）PSA水平为4.9（0.1-125.0）ng/mL。观察到的病理结果概率为：OC疾病74%，EPE 20%，SV+4%，LN+2%。当活检Gleason评分从6（1级组，GG 1）增加到3 + 4（GG 2）时，EPE的概率大幅增加，级别越高，增加越小。与较低的Gleason评分相比，活检Gleason评分9-10（GG 5）的LN+概率显著更高。二元Logistic模型预测EPE、SV+和LN+ vs OC的受试者工作特征曲线下面积分别为0.724、0.856和0.918。接受活检Gleason评分的男性比例
ObjectiveTo update the Partin Tables for prediction of pathological stage in the contemporary setting and examine trends in patients treated with radical prostatectomy (RP) over the past three decades.Patients and MethodsFrom January 2010 to October 2015, 4459 men meeting inclusion criteria underwent RP and pelvic lymphadenectomy for histologically confirmed prostate cancer at the Johns Hopkins Hospital. Preoperative clinical stage, serum prostate-specific antigen (PSA) level, and biopsy Gleason score (i. e. prognostic Grade Group) were used in a polychotomous logistic regression model to predict the probability of pathological outcomes categorised as: organ-confined (OC), extraprostatic extension (EPE), seminal vesicle involvement (SV+), or lymph node involvement (LN+). Preoperative characteristics and pathological findings in men treated with RP since 1983 were collected and clinical-pathological trends were described.ResultsThe median (range) age at surgery was 60 (34-77) years and the median (range) PSA level was 4.9 (0.1-125.0) ng/mL. The observed probabilities of pathological outcomes were: OC disease in 74%, EPE in 20%, SV+ in 4%, and LN+ in 2%. The probability of EPE increased substantially when biopsy Gleason score increased from 6 (Grade Group 1, GG1) to 3 + 4 (GG2), with smaller increases for higher grades. The probability of LN+ was substantially higher for biopsy Gleason score 9-10 (GG5) as compared to lower Gleason scores. Area under the receiver operating characteristic curves for binary logistic models predicting EPE, SV+, and LN+ vs OC were 0.724, 0.856, and 0.918, respectively. The proportion of men treated with biopsy Gleason score