Buskirk et al developed a prognostic score for men who require salvage radiation therapy following an isolated increase in PSA after a radical prostatectomy. This can help identify a patient who may require more aggressive management or may be a candidate for a novel therapy. The authors are from the Mayo Clinic.
Patient selection: prostate cancer with pathologic tumor Stage T2 or T3 treated with radical prostatectomy
Parameters:
(1) pathologic tumor stage of radical prostatectomy specimen
(2) Gleason score
(3) serum PSA prior to salvage radiation therapy
Parameter |
Finding |
Points |
pathologic tumor stage |
T2 |
0 |
|
T3a |
0 |
|
T3b |
1 |
Gleason score |
2 to 6 |
0 |
|
7 |
1 |
|
8, 9 or 10 |
2 |
PSA prior to radiation therapy |
< 0.5 ng/mL |
0 |
|
0.5 to 1.0 ng/mL |
1 |
|
> 1.0 ng/mL |
2 |
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the worse the prognosis.
Total Score |
Probability Relapse Free at 5 Years |
0 or 1 |
70% |
2 |
52% |
3 |
25% |
4 or 5 |
6% |
estimated from Figure 4, page 989
Specialty: Hematology Oncology, Surgery, general, Urology
ICD-10: ,