Popular Prostate
Cancer Staging Does Not Predict Recurrence, Study Finds
Clinical stage was
assigned incorrectly in 35.4% of 3,875 men in a multi-institutional
national disease registry
Nov. 22, 2010 -
A new study challenges the current staging system that determines the
extent or severity of prostate cancer that has not metastasized.
Published early online in CANCER, a peer-reviewed journal of the
American Cancer Society, the study found that there is no link between
localized prostate cancer's clinical stage and a patient's risk of
cancer recurrence after having his prostate removed.
One of the
primary purposes of staging prostate cancers is to help physicians
determine a patient's prognosis. For example, a more advanced clinical
stage should indicate a higher risk of cancer recurrence after
treatment.
Surprisingly,
however, researchers have found that clinical stage is of questionable
utility for predicting disease recurrence after surgical removal of the
prostate (radical prostatectomy) in patients with localized prostate
cancer.
Adam Reese, MD,
of the University of California, San Francisco, and his colleagues
questioned whether staging errors are responsible for this discrepancy.
In other words, do physicians often inaccurately stage prostate cancer
cases, and if so, does this account for the inconsistent reliability of
clinical staging for predicting prostate cancer outcomes?
The
investigators found that clinical stage was assigned incorrectly in 35.4
percent of 3,875 men in a multi-institutional national disease registry.
The majority of
these staging errors occurred because physicians frequently disregarded
the results of transrectal ultrasound tests and incorrectly incorporated
biopsy results when assigning stage.
Even after
correcting these staging errors, however, there was no association
between clinical stage and prostate cancer recurrence after radical
prostatectomy. "Our findings question the utility of our current staging
system for localized prostate cancer," said Dr. Reese.
Definition of
Prostate Cancer Staging
The process of
determining extent of disease in a specific patient in light of all
available information; it is used to help determine appropriate therapy;
there are two staging methods: the Whitmore-Jewett staging
classification (1956) and the more detailed TNM (tumor,
(lymph) nodes,
metastases)
classification (1992) of the American Joint Committee on Cancer and the
International Union Against Cancer. Staging should be subcategorized as
clinical
staging and
pathologic
staging. Clinical stage is based on the
digital rectal
exam findings. Pathologic stage usually relates to what is
found at the time of surgery. The TNM system is now most commonly used.
Researchers studied almost 6,000 senior citizens,
suggest patients be informed about the differences and similarities in
expected outcomes, make treatment decisions with an experienced surgeon
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Feb. 22, 2010
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cardiovascular risk, but unclear whether it’s linked to increased death
from heart disease - Feb. 3, 2010
MIRP, especially with robotic assistance, increased from 1% to 40% of radical prostatectomies from 2001 to
2006,despite limited data on outcomes and costs
Sarcosine is better indicator of advancing disease
than traditional prostate specific antigen test (PSA); it is detected in
urine, researchers hopeful simple urine test can be used
Nov. 22, 2010 -
A new study challenges the current staging system that determines the
extent or severity of prostate cancer that has not metastasized.
Published early online in CANCER, a peer-reviewed journal of the
American Cancer Society, the study found that there is no link between
localized prostate cancer's clinical stage and a patient's risk of
cancer recurrence after having his prostate removed.
