when it comes to prostate cancer be suspicious of the word ” Cure “- The Partin Tables reveal why

















a wise man doesn’t need advice and a fool won’t take it


 







The reason the Partin Tables are so important to the lay person making a decision about what to do about his newly diagnosed prostate cancer is this: Beware of books (Look at the top 10 books on Amazon after searching prostate cancer) that have ” you can cure prostate cancer” , ads or brochures that say they will ” cure you” of prostate cancer. The saying ” it is what it is” in a way applies her. The specifics of your biopsy, Gleason’s and volume of positive cores, your PSA, and your underlying health are the determinates of what you will decide and how you will do with any treatment. If your parameters are unfavorable it is tougher to achieve cure. If your parameters are favorable your chances at cure are better. Blanket statements in an ad or on the cover of a book about cure, I feel, are ingenious and should make a little bell go off in your head and read and act discernibly.

 




The Partin Tables will give you an indication of the “toughness ” of your particular cancer and is an excellent tool in the decision-making process. See the link to the table and get a feel for how to use it. You’ll see that ” cure” isn’t mentioned.

 




Validation Of The Partin Nomogram For Prostate Cancer In A National Sample

 




Main Category: Prostate / Prostate Cancer

 




Also Included In: Cancer / Oncology | Urology / Nephrology

 




Article Date: 21 Jun 2010

 




UroToday.com – Our study investigates the performance of the Partin Nomogram using a cohort of patients identified in the National Cancer Institute, Surveillance Epidemiology, and End Results (SEER) database for the years 2004-2005. The Partin tables [1] attempt to predict the pathologic extent of disease found at radical prostatectomy by categorizing patients into mutually exclusive categories of positive lymph nodes, positive seminal vesicles, extracapsular disease, and organ confined disease. The Partin tables rely on pre-surgical PSA, biopsy Gleason score, and clinical T stage in assigning risk. We investigated the overall discriminatory and predictive performance of the Partin Tables, and also investigated the association of race and age with the Partin Table’s performance.

 




An interesting limitation of our analysis is that we could not use the pre-surgical biopsy Gleason score, but rather used the Gleason score found in the radical prostatectomy specimen. This is a limitation of the SEER database, as the Gleason score is reported from the largest pathological specimen. In the case of radical prostatectomy, it is the pathology specimen, not the pre-surgical biopsy. In essence, our study presumed perfect concordance between the biopsy assigned Gleason score, and the radical prostatectomy specimen assigned Gleason score. Though “over grading” is a well known phenomenon, there are signs that this is improving in the most recent contemporary studies. [2][3] Therefore, we feel that this limitation does not invalidate our analysis.

 




We found that race does not predict for more advanced pathology, when matched by PSA, Gleason score, and clinical T-stage. This was consistent with another large study investigating the association between Race and the performance of the Partin Tables.[4] Interestingly, we found that younger age predicted for more advanced pathology compared to older age, and that the Partin Tables performed the best for young men under 61 years of age. This could be due to a multitude of factors, including the relative youth of the Johns Hopkins Medical Institute cohort (the group of patients used to “build” the Partin Tables), and the greater incidence of benign prostatic hypertrophy – attributable PSA in older men, perhaps increasing the perceived (but not actual) risk of advanced disease in these men. There could also be yet-undefined differences in cancer biology between younger and older men with prostate cancer, not taken into account by Gleason score, PSA, and clinical T-stage.

 




In conclusion, we showed excellent discrimination of the Partin tables for seminal vesicle invasion and positive lymph nodes. However, we found an interesting difference in the performance of the Partin tables between younger and older men.

 













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