Staging for prostate cancer
dc.contributor.author | Roach, Mack | en_US |
dc.contributor.author | Weinberg, Vivian K. | en_US |
dc.contributor.author | Sandler, Howard M. | en_US |
dc.contributor.author | Thompson, Ian | en_US |
dc.date.accessioned | 2007-09-20T18:07:47Z | |
dc.date.available | 2008-04-03T18:48:17Z | en_US |
dc.date.issued | 2007-01-15 | en_US |
dc.identifier.citation | Roach, 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.issn | 0008-543X | en_US |
dc.identifier.issn | 1097-0142 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/55927 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=17167758&dopt=citation | en_US |
dc.description.abstract | BACKGROUND. 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.extent | 179842 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Cancer Research, Oncology and Pathology | en_US |
dc.title | Staging for prostate cancer | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Oncology and Hematology | en_US |
dc.subject.hlbsecondlevel | Public Health | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationother | Department 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 94143-1708 | en_US |
dc.contributor.affiliationother | Department 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, California | en_US |
dc.contributor.affiliationother | Department of Urology and San Antonio Cancer Institute, University of Texas San Antonio, San Antonio, Texas | en_US |
dc.identifier.pmid | 17167758 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/55927/1/22403_ftp.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1002/cncr.22403 | en_US |
dc.identifier.source | Cancer | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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