title: The 2002 AJCC pT2 substages confer no prognostic information on the rate of biochemical recurrence after radical prostatectomy.
abstract: BACKGROUND
  We examined the prognostic value of AJCC pT2 substages in prediction of biochemical recurrence (BCR) after radical prostatectomy (RP), in European patients.
  
  
  METHODS
  A cohort of 1726 RP patients with pT2N0 prostate cancer (PCa) was studied. Multivariate Cox regression models addressed the association between either the 1997 or 1992/2002 pT2 substages after controlling for total PSA, primary and secondary pathologic Gleason scores and surgical margin status and time to PSA recurrence (PSA >0.1 and rising) after RP. Regression coefficients were then used to test the predictive accuracy of multivariate models in a nomogram setting.
  
  
  RESULTS
  PSA recurrence occurred in 80 (4.6%) patients. Mean and median times to recurrence were respectively 28.9 and 24.4 months. In univariate analyses, neither the 1997 (p = 0.48) nor the 1992/2002 pT2 substages (p = 0.054) were predictive of recurrence. In multivariate analyses the lack of significance persisted (1997 p = 0.709; 1992/2002 p = 0.124). When either the 1997 or 1992/2002 pT2 substages were added to a multivariate nomogram without pT2 substage information, its accuracy respectively decreased by 0.8% and 1.1%.
  
  
  CONCLUSIONS
  Our data indicate that pT2 substages offer no incremental value relative to pre-treatment total PSA, surgical margin status and pathologic Gleason scores. Therefore, it might be postulated that it is sufficient to confirm organ confinement according to Partin's pathologic staging.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit and the Department of Urology, University of Montreal Health Center, Montreal, Canada.
authors.forename: Felix K-H
authors.initials: FK
authors.lastname: Chun
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Thierry
authors.initials: T
authors.lastname: Lebeau
authors.forename: Vincent
authors.initials: V
authors.lastname: Fradet
authors.forename: Thomas
authors.initials: T
authors.lastname: Steuber
authors.forename: Jochen
authors.initials: J
authors.lastname: Walz
authors.forename: Thorsten
authors.initials: T
authors.lastname: Schlomm
authors.forename: Christian
authors.initials: C
authors.lastname: Eichelberg
authors.forename: Alexander
authors.initials: A
authors.lastname: Haese
authors.forename: Andreas
authors.initials: A
authors.lastname: Erbersdobler
authors.forename: Michael
authors.initials: M
authors.lastname: McCormack
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Hartwig
authors.initials: H
authors.lastname: Huland
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood*; D015986:Confounding Factors, Epidemiologic; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000517:prevention & control*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen