Analysis of clinical stage T2 prostate cancer: Do current subclassifications represent an improvement? Journal Article
| Authors: | Cagiannos, I.; Graefen, M.; Karakiewicz, P. I.; Ohori, M.; Eastham, J. A.; Rabbani, F.; Fair, W.; Wheeler, T. M.; Hammerer, P. G.; Haese, A.; Erbersdobler, A.; Huland, H.; Scardino, P. T.; Kattan, M. W. |
| Article Title: | Analysis of clinical stage T2 prostate cancer: Do current subclassifications represent an improvement? |
| Abstract: | 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. © 2002 by American Society of Clinical Oncology. |
| Keywords: | adult; cancer survival; controlled study; aged; survival analysis; major clinical study; cancer staging; follow up; neoplasm staging; prostate specific antigen; proportional hazards models; prostate cancer; prostatic neoplasms; survival time; prostatectomy; humans; prognosis; human; male; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 20 |
| Issue: | 8 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2002-04-15 |
| Start Page: | 2025 |
| End Page: | 2030 |
| Language: | English |
| DOI: | 10.1200/jco.2002.08.123 |
| PUBMED: | 11956261 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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