Clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.

<h4>Background</h4>Pathological and clinical stage are associated with prostate cancer-specific survival after prostatectomy. With PSA screening, the post-surgery prognostic utility of clinical stage is debatable in studies seeking to identify new biomarkers. Few studies have investigate...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Maxine M Chen, Jaquelyn L Jahn, John R Barber, Misop Han, Meir J Stampfer, Elizabeth A Platz, Kathryn L Penney
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8daf3c01f615479798bbafbc98d26002
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8daf3c01f615479798bbafbc98d26002
record_format	dspace
spelling	oai:doaj.org-article:8daf3c01f615479798bbafbc98d260022021-12-02T20:15:51ZClinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.1932-620310.1371/journal.pone.0234391https://doaj.org/article/8daf3c01f615479798bbafbc98d260022020-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0234391https://doaj.org/toc/1932-6203<h4>Background</h4>Pathological and clinical stage are associated with prostate cancer-specific survival after prostatectomy. With PSA screening, the post-surgery prognostic utility of clinical stage is debatable in studies seeking to identify new biomarkers. Few studies have investigated clinical stage and lethal prostate cancer association after accounting for pathological stage. We hypothesize that clinical stage provides prognostic information beyond pathological stage in the PSA era.<h4>Methods</h4>Cox regression models tested associations between clinical and pathological stage and lethal prostate cancer among 3,064 participants from the Health Professionals Follow-Up Study and Physicians' Health Study (HPFS/PHS) who underwent prostatectomy. Likelihood ratio tests and c-statistics were used to assess the models' prognostic utility. Equivalent analyses were performed in 16,134 men who underwent prostatectomy at Johns Hopkins.<h4>Results</h4>Independently, clinical and pathological stage were associated (p<0.0001 for both) with rate of lethal prostate cancer in HPFS/PHS. The model with clinical and pathological stage fit significantly better than the model with only pathological stage in all men (p = 0.01) and in men diagnosed during the PSA era (p = 0.04). The mutually adjusted model also improved discriminatory ability. In the Johns Hopkins cohort, the model with clinical and pathological stage improved discriminatory ability and fit significantly better overall (p<0.0001) and in the PSA era (p<0.0001).<h4>Conclusions</h4>Despite stage migration resulting from widespread PSA screening, clinical stage remains associated with progression to lethal prostate cancer independent of pathological stage. Future studies evaluating associations between new factors and poor outcome following prostatectomy should consider including both clinical and pathological stages since the data is already available.Maxine M ChenJaquelyn L JahnJohn R BarberMisop HanMeir J StampferElizabeth A PlatzKathryn L PenneyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 15, Iss 6, p e0234391 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maxine M Chen Jaquelyn L Jahn John R Barber Misop Han Meir J Stampfer Elizabeth A Platz Kathryn L Penney Clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.
description	<h4>Background</h4>Pathological and clinical stage are associated with prostate cancer-specific survival after prostatectomy. With PSA screening, the post-surgery prognostic utility of clinical stage is debatable in studies seeking to identify new biomarkers. Few studies have investigated clinical stage and lethal prostate cancer association after accounting for pathological stage. We hypothesize that clinical stage provides prognostic information beyond pathological stage in the PSA era.<h4>Methods</h4>Cox regression models tested associations between clinical and pathological stage and lethal prostate cancer among 3,064 participants from the Health Professionals Follow-Up Study and Physicians' Health Study (HPFS/PHS) who underwent prostatectomy. Likelihood ratio tests and c-statistics were used to assess the models' prognostic utility. Equivalent analyses were performed in 16,134 men who underwent prostatectomy at Johns Hopkins.<h4>Results</h4>Independently, clinical and pathological stage were associated (p<0.0001 for both) with rate of lethal prostate cancer in HPFS/PHS. The model with clinical and pathological stage fit significantly better than the model with only pathological stage in all men (p = 0.01) and in men diagnosed during the PSA era (p = 0.04). The mutually adjusted model also improved discriminatory ability. In the Johns Hopkins cohort, the model with clinical and pathological stage improved discriminatory ability and fit significantly better overall (p<0.0001) and in the PSA era (p<0.0001).<h4>Conclusions</h4>Despite stage migration resulting from widespread PSA screening, clinical stage remains associated with progression to lethal prostate cancer independent of pathological stage. Future studies evaluating associations between new factors and poor outcome following prostatectomy should consider including both clinical and pathological stages since the data is already available.
format	article
author	Maxine M Chen Jaquelyn L Jahn John R Barber Misop Han Meir J Stampfer Elizabeth A Platz Kathryn L Penney
author_facet	Maxine M Chen Jaquelyn L Jahn John R Barber Misop Han Meir J Stampfer Elizabeth A Platz Kathryn L Penney
author_sort	Maxine M Chen
title	Clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.
title_short	Clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.
title_full	Clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.
title_fullStr	Clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.
title_full_unstemmed	Clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.
title_sort	clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the psa era.
publisher	Public Library of Science (PLoS)
publishDate	2020
url	https://doaj.org/article/8daf3c01f615479798bbafbc98d26002
work_keys_str_mv	AT maxinemchen clinicalstageprovidesusefulprognosticinformationevenafterpathologicalstageisknownforprostatecancerinthepsaera AT jaquelynljahn clinicalstageprovidesusefulprognosticinformationevenafterpathologicalstageisknownforprostatecancerinthepsaera AT johnrbarber clinicalstageprovidesusefulprognosticinformationevenafterpathologicalstageisknownforprostatecancerinthepsaera AT misophan clinicalstageprovidesusefulprognosticinformationevenafterpathologicalstageisknownforprostatecancerinthepsaera AT meirjstampfer clinicalstageprovidesusefulprognosticinformationevenafterpathologicalstageisknownforprostatecancerinthepsaera AT elizabethaplatz clinicalstageprovidesusefulprognosticinformationevenafterpathologicalstageisknownforprostatecancerinthepsaera AT kathrynlpenney clinicalstageprovidesusefulprognosticinformationevenafterpathologicalstageisknownforprostatecancerinthepsaera
_version_	1718374539217338368

Clinical stage provides useful prognostic information even after pathological stage is known for prostate cancer in the PSA era.

Ejemplares similares