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CART Model of Stephenson et al for Outcome Following Radiation Therapy for Recurrent Prostate Cancer After Radical Prostatectomy

Description

Stephenson et al developed a classification and regression tree (CART) model for predicting 4-year progression free survival following radiation therapy in a male with recurrent prostate cancer after radical prostatectomy. This can help identify a patient who may benefit from more aggressive or a novel therapy. The authors are from Cleveland Clinic, Memorial Sloan-Kettering Cancer Center, Mayo Clinic and multiple other cancer centers in the United States and Canada.


 

Patient selection: Gleason scores 4 to 10

 

Parameters:

(1) PSA prior to radiation therapy in ng/mL

(2) Gleason score in the prostatectomy specimen, from 4 to 10

(3) surgical margin at the time of radical prostatectomy

(4) PSA doubling time in months

PSA pre-RT in ng/mL

Gleason Score

Surgical Margin

PSA doubling time

Endpoint

<= 2

4-7

positive

> 10

A

<= 2

4-7

positive

<= 10

B

<= 2

4-7

negative

> 10

C

<= 2

4-7

negative

<= 10

D

<= 2

8-10

positive

> 10

E

<= 2

8-10

positive

<= 10

F

<= 2

8-10

negative

NA

G

> 2

NA

NA

NA

H

 

 

Endpoint

Percent with 4 Year Progression Free Survival

A

69%

B

57%

C

61%

D

48%

E

50%

F

30%

G

18%

H

19%

 

where:

• A patient with a positive surgical margin may show a better progression-free survival than someone with a negative margin. The latter is more likely to present with recurrent disease in a lymph node or distant site.

 


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