Staging Suggestions
June, 2000

Use of data from other studies cited above would help individualize the staging evaluation for each patient. Our suggestions for staging are shown in the tables below. These are conceptual and based partly on the data discussed above. A large scale analysis of such an approach would need to be done since percentages shown below have not been determined by actual patient studies. The tables below show possible predictive results, using the Partin, Narayan, Huncharek, Chybowski, and Oesterling findings and how these results may reflect on our advice for staging studies.

The Partin, Narayan, Bluestein, D’Amico and Lerner analyses, if used routinely for each patient being considered for any local therapy, would indicate the likelihood of OCD as well as the risk for capsular penetration, seminal vesicle invasion and lymph node involvement. This would highlight the need for a more or less intensive staging evaluation. These predictive tables should allow for a frank and honest discussion with the patient about the probability that his cancer may be organ-confined disease and the relative likelihood that a local therapy will truly eradicate disease. Furthermore, these investigations have given us insight as to the value or lack of value of certain radiologic studies. This, too, should focus our efforts more effectively in the patient’s behalf.

As more papers are written on the pre-operative evaluation of the prostate cancer patient and correlated with the extent of disease at surgery, we can further refine the suggestions we make to our patients. There is a serious need for a task force to examine these prognostic tools and create a practical working model that can be used. The predictive algorithms described in this booklet have been converted into computer software for the ease of the newly-diagnosed patient with PC. This information can be accessed through our Website at www.prostate-cancer.org.

Patients should no longer be subjected to whimsical workups that are not based on anything more than the individual physician’s gestalt as to what the patient’s status actually is. Until the time comes when accurate staging is no longer relevant to a successful outcome, we must continue to "do our homework" with each patient. For now, we need to present what we honestly know to the patient and allow the patient to become an active participant in the treatment decision-making processes.

 

Prostate Cancer Research Institute (PCRI)
 

Material provided by PCRI is intended for educational purposes for discussion with your physician and should not be considered as medical advice. Information and opinions expressed on this website are not an endorsement by PCRI for any treatment, product or service.