Understanding the Partin Tables
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From: Sy on 18 Dec 2007 12:23 Leonard, Thanks for the clarification. So if I understand correctly, given my numbers and assuming I were to get a RP , my chance of recurrence would be about 3%. Is that correct? Also, when one says "recurrence" where is the locus? I guess it could be prostate,lymph or bone or all? Sy In article <j6qdnSEFkbf2QPjanZ2dnUVZ_hGdnZ2d(a)comcast.com>, Leonard Evens <len(a)math.northwestern.edu> wrote: > Sy wrote: > > I am beginning to understand the Partin Tables but have some questions: > > > > My "numbers" for purposes of the Partin Tables are: > > > > PSA-3.14 > > Gleason-6 > > Clinical Stage-T1c > > > > Based upon my numbers, the Partin tables show: > > > > > > Organ confined -88 (86-90) > > Extraprostatic extension-11 (10-13) > > Seminal vesicle- 1 (0-1) > > Lymph node -0 (0-0) > > > > As I understand it, that means that the probabliity that the cancer is > > "organ confined" is %88, "extraprostatic" %11 and so forth. Obviously > > the further the cancer has spread from the prostate itself, the more > > "serious" the cancer probably is. > > > > So in trying to understand these numbers, if we have prostate cancer > > our wish would be that it be "organ confined" because we all know that > > very many men die of other causes while having "organ confined" > > prostate cancer. In my case it appears that as long as all my numbers > > (PSA,Gleason, Clinical Stage) remain the same then we can say that the > > odds that my cancer is "organ confined" is about 90%-9 out of 10. > > > > Would appreciate any feedback regarding my analysis of how I understand > > the Partin tables. > > > > Thanks, > > > > Sy > > You have to understand how the Partin tables wer constructed. They took > a large number of men whose diagnoses before surgery was known. They > then analyzed their post surgical pathology reports. So for men whose > cancer was diagnosed as T1c and had a PSA before surgery in a certain > range (indicated in the tables) that contained yours (3.4) and for whom > the Gleason score was 6=3+3, the percentage of cases in which the > cancer was found to be organ confined was 88 percent, the percentage in > which there was extraprostatic extension, but no cancer in the seminal > vesicales was 11 percent, the percentage in which there was cancer in > the seminal vesicles was 1 percent, and there were no cases observed > with cancer in the lymph nodes. > > But what you have to keep in mind that the pathologist when examining > your prostate after surgery can only report what he sees. For example, > some cancer could have escaped the prostate, be somewhere in the sample > and missed by the pathologist or some cancer might have escaped outside > the sample examined by the pathologist. Some, but not all of these > cancers will recur. In addition, not all cancers which the apthologist > finds have escaped the prostate will recur after treatment. So the > Partin tables, while helpful, can't be used to determine the risk of > metastasis at a later date. The only way to do that is to follow a > large number of men for years and see how often the cancer recurs. Note > that in such cases, the cancer didn't pop up out of nowhere. It had > almost certainly already escaped the prostate at the time of surgery > although not found by the pathologist. > > Various researchers have done that work and constructed models from > which they can, with some degree of confidence, predict the likelihood > of recurrence within specified time periods. One place you can find a > reliable calculator of this sort is at the Sloan Kettering website. It > will give you the likelihood of recurrence based on pre-surgical > diagnosis and also the risk based on the results following surgery. > > In a case like yours, I think you will find that the likelihood of > non-recurrence within ten years is something like 97 percent.
From: Sy on 18 Dec 2007 12:26 Roast Beef, I will be getting my PSA tested in early January. Will let you know the results. Thanks for asking. Sy In article <flkcm3p9g27rc2v173p617j5nouqss0lug(a)4ax.com>, rosbif wrote: > On Sat, 15 Dec 2007 17:35:09 -0500, Sy <stuttgart6(a)lycos.com> wrote: > > >It's interesting how people see the same numbers differently. My > >personal interpretation of my numbers is that "I have good numbers for > >my current choice which is "active surveillance". > > No surprise that interpretations differ when we're lost in such > inexact data, hopelessy inadequate science, irrational > optimism/pessimism and the tantalising 'cure'/SE seesaw. > > You say you have good numbers for active surveillance. Partin reports > on a snapshot. What about your doubling time? Since you first posted > here, enough time will have elapsed to enable you to test your 22month > PSA-DT, and of course as an *active* surveillant you'll have had a new > reading. How's that going? > >
From: safire on 18 Dec 2007 12:30 Sy wrote: > Leonard, > > Thanks for the clarification. > > So if I understand correctly, given my numbers and assuming I were to > get a RP , my chance of recurrence would be about 3%. Is that correct? > > > Sy > > No Sy, for that determination you need the data obtained at the time of the RP (the Gleason score may very well differ) and use the Han tables, that were developed for that purpose.
From: Leonard Evens on 19 Dec 2007 22:23
Sy wrote: > Leonard, > > Thanks for the clarification. > > So if I understand correctly, given my numbers and assuming I were to > get a RP , my chance of recurrence would be about 3%. Is that correct? You should really go to the Sloan Kettering website and try it yourself. When I tried it I had to make some assumptions about your diagnosis such as the number of cores which were positive. When you enter all the data, you may find it comes up with a slightly different estimate. But it won't be very different. Also, note that this is the likelihood of recurrence within ten years, not over your entire lifetime. Although it is not too likely, prostate cancer can recur after 15 or more years. Don't worry too much about the exact figures. In a case like yours, if the cancer is treated by an appropriate method, the chances of recurrence are low enough that it doesn't make a lot of sense to spend your time worrying about it. Most likely, you will die of something else. let me emphasize again that all these studies are predictions about what may happen following treatment. You can't draw conclusions from these studies about what might happen if you defer treatment. A certain number of Gleason 6 cases, with relatively low PSA, may in fact be candidates for expectant management, but the studies and statistics supporting that are different from Partin's work and the work of those who developed the Sloan Kettering calculator. > > Also, when one says "recurrence" where is the locus? I guess it could > be prostate,lymph or bone or all? You can find good discussions of this in either Walsh or Scardino. But what they are talking about is rising PSA or less often the appearance of symptoms. Rising PSA is called biochemical recurrence because it precedes often by many years the appearance of symptoms of metastasis. Biochemical recurrence may indicate cancer developing locally in the prostate bed, in which case it is possible, following surgery, to treat it by radiation. Or it could be because of cancer developing at distant sites, in which case hormone therapy would be the appropriate therapy. But often that can be delayed for many years. > > Sy > > > > > > > > In article <j6qdnSEFkbf2QPjanZ2dnUVZ_hGdnZ2d(a)comcast.com>, Leonard > Evens <len(a)math.northwestern.edu> wrote: > >> Sy wrote: >>> I am beginning to understand the Partin Tables but have some questions: >>> >>> My "numbers" for purposes of the Partin Tables are: >>> >>> PSA-3.14 >>> Gleason-6 >>> Clinical Stage-T1c >>> >>> Based upon my numbers, the Partin tables show: >>> >>> >>> Organ confined -88 (86-90) >>> Extraprostatic extension-11 (10-13) >>> Seminal vesicle- 1 (0-1) >>> Lymph node -0 (0-0) >>> >>> As I understand it, that means that the probabliity that the cancer is >>> "organ confined" is %88, "extraprostatic" %11 and so forth. Obviously >>> the further the cancer has spread from the prostate itself, the more >>> "serious" the cancer probably is. >>> >>> So in trying to understand these numbers, if we have prostate cancer >>> our wish would be that it be "organ confined" because we all know that >>> very many men die of other causes while having "organ confined" >>> prostate cancer. In my case it appears that as long as all my numbers >>> (PSA,Gleason, Clinical Stage) remain the same then we can say that the >>> odds that my cancer is "organ confined" is about 90%-9 out of 10. >>> >>> Would appreciate any feedback regarding my analysis of how I understand >>> the Partin tables. >>> >>> Thanks, >>> >>> Sy >> You have to understand how the Partin tables wer constructed. They took >> a large number of men whose diagnoses before surgery was known. They >> then analyzed their post surgical pathology reports. So for men whose >> cancer was diagnosed as T1c and had a PSA before surgery in a certain >> range (indicated in the tables) that contained yours (3.4) and for whom >> the Gleason score was 6=3+3, the percentage of cases in which the >> cancer was found to be organ confined was 88 percent, the percentage in >> which there was extraprostatic extension, but no cancer in the seminal >> vesicales was 11 percent, the percentage in which there was cancer in >> the seminal vesicles was 1 percent, and there were no cases observed >> with cancer in the lymph nodes. >> >> But what you have to keep in mind that the pathologist when examining >> your prostate after surgery can only report what he sees. For example, >> some cancer could have escaped the prostate, be somewhere in the sample >> and missed by the pathologist or some cancer might have escaped outside >> the sample examined by the pathologist. Some, but not all of these >> cancers will recur. In addition, not all cancers which the apthologist >> finds have escaped the prostate will recur after treatment. So the >> Partin tables, while helpful, can't be used to determine the risk of >> metastasis at a later date. The only way to do that is to follow a >> large number of men for years and see how often the cancer recurs. Note >> that in such cases, the cancer didn't pop up out of nowhere. It had >> almost certainly already escaped the prostate at the time of surgery >> although not found by the pathologist. >> >> Various researchers have done that work and constructed models from >> which they can, with some degree of confidence, predict the likelihood >> of recurrence within specified time periods. One place you can find a >> reliable calculator of this sort is at the Sloan Kettering website. It >> will give you the likelihood of recurrence based on pre-surgical >> diagnosis and also the risk based on the results following surgery. >> >> In a case like yours, I think you will find that the likelihood of >> non-recurrence within ten years is something like 97 percent. |