title: A pretreatment table for the prediction of final histopathology after radical prostatectomy in clinical unilateral T3a prostate cancer.
abstract: OBJECTIVE
  Partin tables are the most widely used tool to predict histopathologic stage after radical prostatectomy (RP) in organ-confined tumors. Such a predictive table in clinical T3 disease is still lacking. Our objective was to create a reference table for clinical unilateral T3a prostate cancer.
  
  
  METHODS
  Between 1987 and 2004, 200 patients with clinical unilateral T3a disease underwent a RP and bilateral pelvic lymphadenectomy at our institution. No patient had received neoadjuvant treatment. Patients were divided into three prostate-specific antigen (PSA) subgroups (<or=10 ng/ml, >10-20 ng/ml, and >20 ng/ml) and two biopsy Gleason sum (GS) subgroups (<or=7 [3+4] and >or=7 [4+3]). These parameters were used in the table as predictors for final histopathology. Margin and nodal status were also recorded. The multinomial log-linear regression analysis was used to construct the table.
  
  
  RESULTS
  The table stratifies patients into six demarcated risk groups. In the first group, consisting of patients with PSA <or=10 and GS <or=7 (3+4), understaging was only 6% (5% pT3b and 1% pT4). The risk for understaging cT3a prostate cancer increases further with increasing PSA and GS. In the sixth group, consisting of patients with PSA >20 and GS >or=7 (4+3), understaging was as high as 68% (44% pT3b and 22% pT4). Receiver operating characteristic analyses showed good accurate predictive ability of the table for seminal vesicle involvement and adjacent structure involvement, with moderate predictive ability for extraprostatic extension only.
  
  
  CONCLUSIONS
  We present a table combining preoperative serum PSA and biopsy GS to predict histopathologic results in clinical unilateral T3a prostate cancer. The table may provide a basis for decision-making and patient counseling before treating this cancer.
authors.affiliation: Department of Urology, University Hospitals Leuven, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Joniau
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Hsu
authors.forename: Evelyne
authors.initials: E
authors.lastname: Lerut
authors.forename: Anthony
authors.initials: A
authors.lastname: Van Baelen
authors.forename: Karin
authors.initials: K
authors.lastname: Haustermans
authors.forename: Tania
authors.initials: T
authors.lastname: Roskams
authors.forename: Raymond
authors.initials: R
authors.lastname: Oyen
authors.forename: Hein
authors.initials: H
authors.lastname: Van Poppel
mesh_terms: D000328:Adult; D000368:Aged; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010336:Pathology / Q000706:statistics & numerical data; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*