Background:
This investigation was conducted to develop an enhanced prognostic system based on readily available and independently predictive tumor-related factors for patients with clinically localized prostate carcinoma.
Methods:
The outcome of 500 patients treated solely with irradiation for clinical tnm classifications t1-4, no or nx, mo prostate carcinoma was used to identify factors independently associated with disease relapse. logistic regression constructed a risk score equation, and optimized cutoff points to characterize patient groups with low, intermediate, or high risks for relapse were established with receiver operating characteristic curve analysis.
Results:
Clinical tumor stage (p < 0.00001), gleason score (p = 0.0002), and pretherapy serum prostate specific antigen (p < 0.00001) were independently associated with clinical or biochemical relapse. these factors were included in a risk score equation that defined patient groups with a distinctly different outcome. for the low, intermediate, and high risk groups, the relapse-free probabilities at 5 years after irradiation were 92%, 67%, and 24%, respectively (p < 0.00001).
Conclusions:
Readily available, pretherapy disease-related characteristics formed the basis of an enhanced prognostic system for patients with clinically localized prostate carcinoma. a multivariate prognostic system of this nature estimated patient prognosis in a more exacting fashion than a system exclusively based on anatomic factors.