Updated tool to more effectively predict spread of prostate cancer is now available

An updated version of the Partin Tables, a tool to help men with prostate cancer and their doctors  better assess the chance of a surgical cure, has been developed.

The Partin Tables model is based on a patient's prostate specific antigen (PSA) level, Gleason score (a number from 2 to 10 that estimates the aggressiveness of tumors removed during a biopsy based on their appearance under a microscope), and clinical stage—the extent to which a tumor can be felt during a digital exam.

Decisions about treatment for prostate cancer are very complex and depend on a variety of factors, including whether the cancer is confined to the prostate or whether it has spread to the edge of the gland, seminal vesicles, lymph nodes, or elsewhere in the body. Data for the Partin Tables, first published in 1993, have been based on the outcomes for more than 20,000 men who underwent prostate removal, or radical prostatectomy (RP), at Johns Hopkins over the past three decades.

“Twenty years ago, before widespread adoption of PSA for early detection, many men were diagnosed with prostate cancer after their cancer had spread. Today, the vast majority of men are diagnosed when the cancer is still confined to the prostate, giving them a much better chance of a cure with a surgical removal of the prostate,” said Alan W. Partin, MD, PhD, professor and director of urology at Johns Hopkins University School of Medicine and creator of the Partin Tables.

The new Partin Tables show that certain categories of men who were previously not thought to have a good prognosis actually could be cured with surgery. For example, men with a biopsy Gleason score of 8 and above previously were not thought to be good candidates for surgery because of the likelihood that the cancer had spread. The new data show a higher probability of a cure with surgery even if a man's Gleason score is 8. Scores of 9 and 10 are still considered high risk, indicating that the cancer likely has spread.

“The updated Partin Tables will significantly improve the ability of physicians to counsel patients on the extent of their disease and help them make treatment decisions, such as whether surgery is warranted and, if so, whether lymph nodes also should be removed during surgery,” Partin said. “If there is a high probability that the cancer has spread, treatment options include radiation, chemotherapy, and hormonal therapy.”

To access the updated Partin Tables, go to http://urology.jhu.edu/prostate/partintables.php. This updated tool was published in the British Journal of Urology International (2012; doi:10.1111/j.1464-410X.2012.11324.x).

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