Prognostic Score of Pisansky et al for Clinically Localized Carcinoma of the Prostate

 

Patient inclusion:

(1) T1-T4, NX or N0, M0 (localized disease)

(2) irradiated for clinically localized adenocarcinoma of the prostate

 

Parameters:

(1) tumor stage (T1, T2, T3 or T4)

(2) Gleason score (sum of 2 predominant Gleason Grades 1-5; score range 2-10)

(3) serum PSA in ng/mL

Parameter	Finding	Risk Value
tumor stage	Stage T1 or T2	0
	Stage T3 or T4	1
Gleason score	Score 2-6	0
	Score 7-10	1

 

risk score =

= (1.07 * (tumor stage risk value)) + (1.21 * (Gleason score risk value)) + (1.2 * (LN(PSA in ng/mL)))

 

Interpretation:

• minimum value: < -2

• maximum value: > 7 (dependent on serum PSA)

 

Risk Score	Risk Group	Relapse Free within 5 years of Radiation Therapy (95% CI)
< 3.1	low	92% (87-97%)
3.1 - 4.9	intermediate	67% (58-78%)
> 4.9	high	24% (15-38%)

 

Limitations:

• In Table 1, page 2156, the coefficients for the logistic regression model give the tumor stage coefficient as 1.21 and the Gleason score coefficient as 1.07, which are the reverse for the values in the equation given.