MATERIAL PROVIDED BY PCRI IS INTENDED FOR EDUCATIONAL PURPOSES AND SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE
Prostate Cancer Algorithms/Nomograms and Software
Predictive algorithms and nomograms combine multiple variables to provide information that is statistically more significant than any individual variable. A nomogram is “an objective tool that uses an algorithm or mathematical formula to predict the probability of an outcome”. These tools can give probabilities of cancer location or of treatment success, based on scientific studies done with hundreds or thousands of patients. While these may provide some guidance, remember that they are not based on treatments using techniques as practiced today (such as IMRT). Algorithms/nomograms may be valuable for evaluating the potential extent of your disease and your risk of recurrence but they do not determine your outcome. You should discuss the results with your own physicians.
The information required is normally available on your medical records. You should get copies of them if you do not have them.
Many algorithms have been published in the peer-reviewed literature. The most familiar algorithm is derived from the work of Dr. Alan Partin et al from the Johns Hopkins Medical Center to predict extent of prostate cancer. It uses prostate-specific antigen level, clinical stage, and biopsy Gleason score. The most recent “Partin Tables”, based on cases from 2000 to 2005, are available from the Johns Hopkins website at: http://urology.jhu.edu/prostate/partintables.php
The Johns Hopkins website also has the Han Tables which provide two models at: http://urology.jhu.edu/prostate/hanTables.php
1. Preoperative Prediction of recurrence probability following surgery using the available information BEFORE the surgery (PSA level, biopsy Gleason score, and clinical stage)
2. Postoperative Prediction of recurrence probability following surgery using the available information BEFORE AND AFTER the surgery (PSA level, surgical Gleason score, and pathological stage)
Additional nomograms can be found in our Nov. 2005 PCRI Insights issue. See Using Nomograms to Predict Pathological Stage and Treatment Outcome
PSADT should be based on at least three values separated by at least three months each. PSADT is best calculated with a mathematical log-slope method. You will find a good PSA Doubling time calculator and several other nomograms available from Memorial Sloan Kettering at: http://www.mskcc.org/mskcc/html/10088.cfm
PCRI Software
We currently have two pieces of software available via request to help@pcri.org.
Prostate Cancer Tools II
PC Tools II contains a collection of computer routines that automate many key prostate cancer algorithms based on over 20 published studies. It was created by Dr. Glenn Tisman, a Medical Oncologist in Whittier California. There is a description of the functions within PC Tools II in the May 2001 PCRI Insights Prostate Cancer Tools II: Software to Aid in Patient Counseling
Tumor Volume Calculator
This is an Excel spreadsheet that combines the work of Aihara et al, D'Amico et al and Stamey et al to derive a calculated tumor volume of prostate cancer that would be expected at radical prostatectomy based on PSA value, gland volume and Gleason score.