Correlation of Clinical Stage, Serum Prostatic Acid Phosphatase and Preoperative Gleason Grade with Final Pathological Stage in 275 Patients with Clinically Localized Adenocarcinoma of the Prostate

No AccessJournal of Urology1 Jul 1987Correlation of Clinical Stage, Serum Prostatic Acid Phosphatase and Preoperative Gleason Grade with Final Pathological Stage in 275 Patients with Clinically Localized Adenocarcinoma of the Prostate Joseph E. Oesterling, Charles B. Brendler, Jonathan I. Epstein, Allyn W. Kimball, and Patrick C. Walsh Joseph E. OesterlingJoseph E. Oesterling More articles by this author , Charles B. BrendlerCharles B. Brendler More articles by this author , Jonathan I. EpsteinJonathan I. Epstein More articles by this author , Allyn W. KimballAllyn W. Kimball More articles by this author , and Patrick C. WalshPatrick C. Walsh More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)43003-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail The usefulness of clinical stage, serum prostatic acid phosphatase and preoperative Gleason grade in predicting final pathological stage in patients with adenocarcinoma of the prostate remains controversial. To determine the predictive value of these 3 preoperative variables we reviewed 275 patients with clinically localized disease who were treated between April 1982 and February 1986. All patients were examined preoperatively and subsequently were operated upon by 1 urologist. Serum prostatic acid phosphatase was determined in all patients by the Roy method using thymolphthalein monophosphate as the substrate. The Gleason grade of each prostatic biopsy specimen was determined preoperatively by 1 pathologist, who also examined the final pathological specimen with respect to capsular penetration, and seminal vesicle and pelvic lymph node involvement. Using logistic regression analysis with the likelihood ratio chi-square test, clinical stage and Gleason grade had a direct correlation with capsular penetration (p less than 0.0001 and less than 0.0001, respectively), seminal vesicle involvement (p less than 0.0001 and less than 0.0001, respectively) and positive lymph nodes (p less than 0.0001 and less than 0.0002, respectively). Within the normal range of values (0.0 to 0.8IU/1.) serum prostatic acid phosphatase correlated directly with capsular penetration (p less than 0.003) and seminal vesicle involvement (p less than 0.01) but not with lymph node involvement (p equals 0.08). Again with logistic regression analysis we determined that the best predictors of final pathological stage are not individual variables but models that use combinations of preoperative variables. The models generated are as follows: capsular penetration—serum prostatic acid phosphatase and Gleason grade (p less than 0.00001), seminal vesicle involvement—clinical stage and Gleason grade (p less than 0.00001), and lymph node involvement—clinical stage and Gleason grade (p less than 0.00001). With these models probability plots have been constructed so that the final pathological stage in patients with clinically localized prostatic cancer can be predicted preoperatively. © 1987 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySim H, Telesca D, Culp S, Ellis W, Lange P, True L and Lin D (2018) Tertiary Gleason Pattern 5 in Gleason 7 Prostate Cancer Predicts Pathological Stage and Biochemical RecurrenceJournal of Urology, VOL. 179, NO. 5, (1775-1779), Online publication date: 1-May-2008.Naito S, Kuroiwa K, Kinukawa N, Goto K, Koga H, Ogawa O, Murai M and Shiraishi T (2018) Validation of Partin Tables and Development of a Preoperative Nomogram for Japanese Patients With Clinically Localized Prostate Cancer Using 2005 International Society of Urological Pathology Consensus on Gleason Grading: Data From the Clinicopathological Research Group for Localized Prostate CancerJournal of Urology, VOL. 180, NO. 3, (904-910), Online publication date: 1-Sep-2008.BORQUE A, SANZ G, ALLEPUZ C, PLAZA L, GIL P and RIOJA L (2018) THE USE OF NEURAL NETWORKS AND LOGISTIC REGRESSION ANALYSIS FOR PREDICTING PATHOLOGICAL STAGE IN MEN UNDERGOING RADICAL PROSTATECTOMY: A POPULATION BASED STUDYJournal of Urology, VOL. 166, NO. 5, (1672-1678), Online publication date: 1-Nov-2001.HAN M, PARTIN A, PIANTADOSI S, EPSTEIN J and WALSH P (2018) ERA SPECIFIC BIOCHEMICAL RECURRENCE-FREE SURVIVAL FOLLOWING RADICAL PROSTATECTOMY FOR CLINICALLY LOCALIZED PROSTATE CANCERJournal of Urology, VOL. 166, NO. 2, (416-419), Online publication date: 1-Aug-2001.BLUTE M, BERGSTRALH E, PARTIN A, WALSH P, KATTAN M, SCARDINO P, MONTIE J, PEARSON J, SLEZAK J and ZINCKE H (2018) VALIDATION OF PARTIN TABLES FOR PREDICTING PATHOLOGICAL STAGE OF CLINICALLY LOCALIZED PROSTATE CANCERJournal of Urology, VOL. 164, NO. 5, (1591-1595), Online publication date: 1-Nov-2000.O'Dowd G, Veltri R, Orozco R, Miller M and Oesterling J (2018) Update on the Appropriate Staging Evaluation for Newly Diagnosed Prostate CancerJournal of Urology, VOL. 158, NO. 3, (687-698), Online publication date: 1-Sep-1997.Bostwick D, Qian J, Bergstralh E, Dundore P, James D, Myers R and Oesterling J (2018) Prediction of Capsular Perforation and Seminal Vesicle Invasion in Prostate CancerJournal of Urology, VOL. 155, NO. 4, (1361-1367), Online publication date: 1-Apr-1996.Stone N, Stock R and Unger P (2018) Indications for Seminal Vesicle Biopsy and Laparoscopic Pelvic Lymph Node Dissection in Men With Localized Carcinoma of ProstateJournal of Urology, VOL. 154, NO. 4, (1392-1396), Online publication date: 1-Oct-1995.Loch T, McNeal J and Stamey T (2018) Interpretation of Bilateral Positive Biopsies in Prostate CancerJournal of Urology, VOL. 154, NO. 3, (1078-1083), Online publication date: 1-Sep-1995.Sgrignoli A, Walsh P, Steinberg G, Steiner M and Epstein J (2018) Prognostic Factors in Men with Stage D1 Prostate Cancer: Identification of Patients Less Likely to Have Prolonged Survival After Radical ProstatectomyJournal of Urology, VOL. 152, NO. 4, (1077-1081), Online publication date: 1-Oct-1994.Gibbons R (2018) Re: The Contemporary Incidence of Lymph Node Metastases in Prostate Cancer: Implications for Laparoscopic Lymph Node Dissection, by J. 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(2018) Reply by AuthorsJournal of Urology, VOL. 140, NO. 3, (539-539), Online publication date: 1-Sep-1988. Volume 138Issue 1July 1987Page: 92-98 Advertisement Copyright & Permissions© 1987 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Joseph E. Oesterling More articles by this author Charles B. Brendler More articles by this author Jonathan I. Epstein More articles by this author Allyn W. Kimball More articles by this author Patrick C. Walsh More articles by this author Expand All Advertisement Loading ...