title: The T classification of clinically localized prostate cancer. An appraisal based on disease outcome after radiation therapy.
abstract: BACKGROUND
  This study was performed to evaluate the use of the 1992 International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) T categories for localized prostate cancer treated with radiation therapy and to compare the prognostic power of this system with the Whitmore-Jewett scheme.
  
  
  METHODS
  The outcome for 427 men with Stages A2-C or T1a-T4b prostate cancers, followed for a mean of 32 months after treatment, was evaluated for relapse or rising prostate-specific antigen (PSA) levels, disease relapse, metastatic failure, and local recurrence relative to the two staging systems. Univariate and multivariate analysis was used to compare the two staging systems. The T categories were based on digital rectal examination.
  
  
  RESULTS
  At 5 years, the actuarial incidence of relapse or rising PSA level was as follows: Stage A2, 29%; Stage B, 41%; Stage C, 62%. The corresponding results according to T category were as follows: T1a, 0%; T1b, 37%; T1c, 23%; T2a, 39%; T2b, 38%; T2c, 42%; T3a, 53%; T3c, 68%; T4b, greater than 75%. Too few patients were in the T3b and T4a categories. The following five-category grouping was significantly superior prognostically to the Whitmore-Jewett system: T1a, T1c, T1b/T2, T3, T4. The actuarial incidences of relapse or rising PSA at 5 years were as follows: T1a, 0%; T1c, 23%; T1b/T2, 41%; T3, 61%; and T4, 75%. No differences were evident within the T2 or T3 categories.
  
  
  CONCLUSIONS
  The current UICC/AJCC system appears to be a valid method for categorizing a primary prostate carcinoma. This system defines a greater number of meaningful tumor categories and is prognostically superior to the traditional Whitmore-Jewett scheme.
authors.affiliation: Department of Clinical Radiotherapy, University of Texas M. D. Anderson Cancer Center, Houston 77030.
authors.forename: G K
authors.initials: GK
authors.lastname: Zagars
authors.forename: F B
authors.initials: FB
authors.lastname: Geara
authors.forename: A
authors.initials: A
authors.lastname: Pollack
authors.forename: A C
authors.initials: AC
authors.lastname: von Eschenbach
mesh_terms: D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy* / Q000556:secondary; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010173:Palpation; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy*; D015996:Survival Rate; D017211:Treatment Failure; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen