Cheng et al identified factors affecting survival following radical prostatectomy for prostate cancer. The authors are from Indiana and Yale Universities.
Parameters seen in a radical prostatectomy specimen:
(1) percent of the tumor that is pattern 4 and 5 (tumors with Gleason scores 7 to 10)
(2) metastases to lymph nodes
percent of tumor that is Grade 4 or 5 =
= (percent of tumor that is Grade 4) + (percent of tumor that is Grade 5)
Percent 4+5
10 Year Cancer Specific Survival
0%
100%
1 - 20%
85%
>= 21%
67%
The hazard ratio with lymph node metastases was 20.
Factors associated with percent patterns 4 + 5:
(1) high Gleason score
(2) positive surgical margins
(3) lymph node metastases
(4) perineural invasion
(5) invasion beyond the prostate capsule
The presence of distant metastases would be another significant prognostic factor, but this information would not be part of the radical prostatectomy specimen.
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