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dc.contributor.authorRoach, Macken_US
dc.contributor.authorWeinberg, Vivianen_US
dc.contributor.authorSandler, Howarden_US
dc.contributor.authorThompson, Ianen_US
dc.date.accessioned2007-09-20T18:07:47Z
dc.date.available2008-04-03T18:48:17Zen_US
dc.date.issued2007-01-15en_US
dc.identifier.citationRoach, Mack; Weinberg, Vivian; Sandler, Howard; Thompson, Ian (2007). "Staging for prostate cancer." Cancer 109(2): 213-220. <http://hdl.handle.net/2027.42/55927>en_US
dc.identifier.issn0008-543Xen_US
dc.identifier.issn1097-0142en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/55927
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=17167758&dopt=citationen_US
dc.description.abstractBACKGROUND. The American Joint Committee on Cancer (AJCC) staging system for prostate cancer is based primarily based on clinical tumor (T) classification. In this article, the authors summarize arguments for incorporating additional pretreatment parameters and creating a new staging system for prostate cancer. METHODS. Men with localized prostate cancer who received treatment with external beam radiation alone were analyzed using the 1997 AJCC staging system compared with a system that included pretreatment prostate-specific antigen (pPSA) level and Gleason score (GS). Multivariate analyses using a Cox proportional-hazards model were carried out to evaluate T classification, GS, and pPSA as predictors of overall survival (OS), disease-specific survival (DSS), and freedom from PSA failure (FFPF). RESULTS. Based on pretreatment characteristics in a series of contemporary patients, only 0.6% of patients were classified with AJCC stage I disease, 16.0% were classified with AJCC stage III disease, and 83.4% were classified with AJCC stage II disease. Multivariate analyses indicated the independent statistical significance of T classification, GS, and pPSA in predicting OS, DSS, and FFPF (model chi-square value, P < .0001 for each). Using these 3 predictors, subsets of patients who had similar outcomes were combined to provide examples of the insensitivity of the AJCC system for predicting outcomes. Incorporating pPSA and GS allowed the identification of differences in OS, DSS, and FFPF for subsets of patients with AJCC stage II disease ( P < .0001, P = .005, and P < .0001, respectively). CONCLUSIONS. The current AJCC staging system does not divide contemporary patients with prostate cancer into prognostic subgroups and does not identify patients who have comparable biochemical control and survival. The AJCC staging system for prostate cancer should be changed to incorporate pPSA, GS, and risk stratification. Cancer 2007. © 2006 American Cancer Society.en_US
dc.format.extent179842 bytes
dc.format.extent3118 bytes
dc.format.mimetypeapplication/pdf
dc.format.mimetypetext/plain
dc.publisherWiley Subscription Services, Inc., A Wiley Companyen_US
dc.subject.otherLife and Medical Sciencesen_US
dc.subject.otherCancer Research, Oncology and Pathologyen_US
dc.titleStaging for prostate canceren_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelOncology and Hematologyen_US
dc.subject.hlbsecondlevelPublic Healthen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationotherDepartment of Radiation Oncology, University of California San Francisco Comprehensive Cancer Center, University of California San Francisco, San Francisco, California ; Department of Urology, University of California San Francisco Comprehensive Cancer Center, University of California San Francisco, San Francisco, California ; Fax: (415) 353-9883. ; Department of Radiation Oncology, University of California San Francisco Comprehensive Cancer Center, 1600 Divisadero Street, Suite 1031, San Francisco, CA 94143-1708en_US
dc.contributor.affiliationotherDepartment of Radiation Oncology, University of California San Francisco Comprehensive Cancer Center, University of California San Francisco, San Francisco, California ; Biostatistics Core, University of California San Francisco Comprehensive Cancer Center, University of California San Francisco, San Francisco, Californiaen_US
dc.contributor.affiliationotherDepartment of Urology and San Antonio Cancer Institute, University of Texas San Antonio, San Antonio, Texasen_US
dc.identifier.pmid17167758en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/55927/1/22403_ftp.pdfen_US
dc.identifier.doihttp://dx.doi.org/10.1002/cncr.22403en_US
dc.identifier.sourceCanceren_US
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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