title: Validation of a staging system for evaluating prognosis in prostate cancer.
abstract: BACKGROUND
  The purposes of our research were to validate a previously published clinical-anatomic staging system for evaluating prognosis in prostate cancer and to explore the predictive ability of additional factors.
  
  
  METHODS
  All patients diagnosed with prostate cancer by physicians affiliated with Yale-New Haven Hospital during 1991 were eligible for the study. Patient and tumor characteristics at baseline were extracted from medical records with up to five-year follow-up for mortality. The original system was validated using Cox proportional hazards analysis and conjunctive consolidation. Prostate specific antigen (PSA) and Gleason score were also explored as factors to be included in an updated staging system.
  
  
  RESULTS
  Five-year survival was 76% among 121 patients included in the study. The original staging system, when applied to the current cohort, was validated: Five-year survival ranged from 100% (low-risk) to 27% (high-risk). PSA and Gleason score were associated with survival but did not change results substantially in this population.
  
  
  CONCLUSIONS
  By predicting distinct mortality outcomes in men with prostate cancer, prognostic staging systems can be used to help patients and physicians make informed treatment decisions.
authors.affiliation: Department of Medicine, Yale University School of Medicine, New Haven, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Anderson
authors.forename: S
authors.initials: S
authors.lastname: Patil
authors.forename: A
authors.initials: A
authors.lastname: Kamina
authors.forename: D F
authors.initials: DF
authors.lastname: Penson
authors.forename: P
authors.initials: P
authors.lastname: Peduzzi
authors.forename: J
authors.initials: J
authors.lastname: Concato
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D016019:Survival Analysis
chemical_list: D017430:Prostate-Specific Antigen