title: Pretreatment tables predicting pathologic stage of locally advanced prostate cancer.
abstract: BACKGROUND
  Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa.
  
  
  OBJECTIVE
  To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice.
  
  
  METHODS
  This was a multicenter retrospective cohort study including 759 consecutive patients with cT3a PCa treated with RP between 1987 and 2010.
  
  
  METHODS
  Retropubic RP and pelvic lymphadenectomy.
  
  
  METHODS
  Patients were divided into pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (GS) subgroups. These parameters were used to construct tables predicting pathologic outcome and the presence of positive lymph nodes (LNs) after RP for cT3a PCa using ordinal logistic regression.
  
  
  CONCLUSIONS
  In the model predicting pathologic outcome, the main effects of biopsy GS and pretreatment PSA were significant. A higher GS and/or higher PSA level was associated with a more unfavorable pathologic outcome. The validation procedure, using a repeated split-sample method, showed good predictive ability. Regression analysis also showed an increasing probability of positive LNs with increasing PSA levels and/or higher GS. Limitations of the study are the retrospective design and the long study period.
  
  
  CONCLUSIONS
  These novel tables predict pathologic stage after RP for patients with cT3a PCa based on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa.
  
  
  RESULTS
  Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment.
authors.affiliation: Department of Urology, University Hospitals, Leuven, Belgium. Electronic address: steven.joniau@uzleuven.be.
authors.forename: Steven
authors.initials: S
authors.lastname: Joniau
authors.affiliation: Department of Urology, University of Bern, Bern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Spahn
authors.affiliation: Department of Urology, San Raffaele Vita e Salute University, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.affiliation: Department of Urology, San Raffaele Vita e Salute University, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gandaglia
authors.affiliation: Department of Urology, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tombal
authors.affiliation: Department of Urology, University Hospitals, Leuven, Belgium.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Tosco
authors.affiliation: Department of Urology, University of Piemonte Orientale, Novara, Italy.
authors.forename: Giansilvio
authors.initials: G
authors.lastname: Marchioro
authors.affiliation: Department of Urology, University Hospitals, Leuven, Belgium.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Department of Urology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Walz
authors.affiliation: Department of Urology, Julius Maximilians Universität Würzburg, Würzburg, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Kneitz
authors.affiliation: Department of Urology, Community Hospital Karlsruhe, Karlsruhe, Germany.
authors.forename: Pia
authors.initials: P
authors.lastname: Bader
authors.affiliation: Department of Urology, Community Hospital Karlsruhe, Karlsruhe, Germany.
authors.forename: Detlef
authors.initials: D
authors.lastname: Frohneberg
authors.affiliation: Department of Urology, University of Turin, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tizzani
authors.affiliation: Department of Urology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.affiliation: Department of Urology, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: van Cangh
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.affiliation: Department of Urology, San Raffaele Vita e Salute University, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.affiliation: Department of Urology, University Hospitals, Leuven, Belgium.
authors.forename: Hein
authors.initials: H
authors.lastname: van Poppel
authors.affiliation: Department of Urology, University of Turin, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gontero
mesh_terms: D001706:Biopsy; D003661:Decision Support Techniques; D005060:Europe; D006801:Humans; D007610:Kallikreins / Q000097:blood; D016015:Logistic Models; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018579:Patient Selection; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Locally advanced prostate cancer; Pretreatment tables; Prostate cancer; Radical prostatectomy