Patient: clinical (not pathologic) stage T2b or T2c
Parameters for proportional hazard multiple regression model:
(1) sigmoid transformation of the preoperative PSA (see chapter 16)
(2) Gleason score on the prostatectomy specimen
(3) tumor confinement in the radical prostatectomy specimen
|
Parameter
|
Finding
|
Points
|
|
specimen confinement
|
specimen confined
|
0
|
|
|
not specimen confined
|
1
|
where:
• The tumor was termed "not specimen confined" as (a) capsular penetration AND (b) one or more of the following: positive surgical margin, positive lymph node, and/or positive seminal vesicle.
relative risk of recurrence =
= (0.061 * (transformed PSA)) + (0.54 * (Gleason score)) + (1.87 * (points for specimen confinement))
Interpretation:
• The higher the score the greater the risk of PSA recurrence.
|
Relative Risk
|
Risk Group
|
|
< 4.0
|
low
|
|
4.0 to 5.74
|
intermediate
|
|
>= 5.75
|
high
|
where:
• The paper uses 5.75 in the tables and text, but 5.57 in the figures.
• A value of 5.75 is unspecified in the paper (intermediate group is < 5.75 and high risk is > 5.75).
