Is clinical stage T2c prostate cancer an intermediate- or high-risk disease?

Zachary Klaassen, Abhay A. Singh, Lauren E. Howard, Zhaoyong Feng, Bruce Trock, Martha K. Terris, William J. Aronson, Matthew R. Cooperberg, Christopher L. Amling, Christopher J. Kane, Alan Wayne Partin, Misop Han, Stephen J. Freedland

Research output: Contribution to journalArticle

Abstract

Background Clinical stage T2c (cT2c) is an indeterminate factor in prostate cancer (PC) risk stratification. According to the D'Amico grouping and American Urological Association guidelines, cT2c is a high risk, whereas the National Comprehensive Cancer Network and the European Urological Association classify cT2c as an intermediate risk. This study assessed whether cT2c tumors without other high-risk factors (clinical stage T2c, not otherwise specified [cT2c-NOS]) behaved as an intermediate or high risk through an analysis of biochemical recurrence (BCR) after radical prostatectomy. Methods Two thousand seven hundred fifty-nine men from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database and 12,900 men from Johns Hopkins Hospital (JHH) from 1988-2011 and 1982-2012, respectively, were analyzed. Patients were grouped into low-risk (prostate-specific antigen [PSA] <10 ng/mL, Gleason sum ≤ 6, and cT1-T2a), intermediate-risk (PSA = 10-20 ng/mL, Gleason sum = 7, or cT2b), and high-risk PC categories (PSA > 20 ng/mL, Gleason sum = 8-10, or cT3). Men with cT2c tumors who were not otherwise at high risk (ie, PSA<20 ng/mL and Gleason sum <8) were placed into a separate category termed cT2c-NOS. Associations between cT2c-NOS and intermediate- and high-risk patients and BCR were tested with the log-rank test and Cox proportional analysis models. Results Ninety-nine men (4%) from SEARCH and 202 men (2%) from JHH had tumors classified as cT2c-NOS. The cT2c-NOS patients had a BCR risk similar to that of the intermediate-risk patients (SEARCH, P =.27; JHH, P =.23) but a significantly lower BCR risk in comparison with the high-risk patients (SEARCH, P

Original languageEnglish (US)
Pages (from-to)1414-1421
Number of pages8
JournalCancer
Volume121
Issue number9
DOIs
StatePublished - May 1 2015

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Prostatic Neoplasms
Cancer Care Facilities
Recurrence
Prostate-Specific Antigen
Neoplasms
Prostatectomy
Databases
Guidelines

Keywords

  • biochemical recurrence
  • clinical staging
  • D'Amico risk stratification
  • Gleason score
  • prostate cancer
  • prostate-specific antigen
  • radical prostatectomy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Klaassen, Z., Singh, A. A., Howard, L. E., Feng, Z., Trock, B., Terris, M. K., ... Freedland, S. J. (2015). Is clinical stage T2c prostate cancer an intermediate- or high-risk disease? Cancer, 121(9), 1414-1421. https://doi.org/10.1002/cncr.29147

Is clinical stage T2c prostate cancer an intermediate- or high-risk disease? / Klaassen, Zachary; Singh, Abhay A.; Howard, Lauren E.; Feng, Zhaoyong; Trock, Bruce; Terris, Martha K.; Aronson, William J.; Cooperberg, Matthew R.; Amling, Christopher L.; Kane, Christopher J.; Partin, Alan Wayne; Han, Misop; Freedland, Stephen J.

In: Cancer, Vol. 121, No. 9, 01.05.2015, p. 1414-1421.

Research output: Contribution to journalArticle

Klaassen, Z, Singh, AA, Howard, LE, Feng, Z, Trock, B, Terris, MK, Aronson, WJ, Cooperberg, MR, Amling, CL, Kane, CJ, Partin, AW, Han, M & Freedland, SJ 2015, 'Is clinical stage T2c prostate cancer an intermediate- or high-risk disease?', Cancer, vol. 121, no. 9, pp. 1414-1421. https://doi.org/10.1002/cncr.29147
Klaassen Z, Singh AA, Howard LE, Feng Z, Trock B, Terris MK et al. Is clinical stage T2c prostate cancer an intermediate- or high-risk disease? Cancer. 2015 May 1;121(9):1414-1421. https://doi.org/10.1002/cncr.29147
Klaassen, Zachary ; Singh, Abhay A. ; Howard, Lauren E. ; Feng, Zhaoyong ; Trock, Bruce ; Terris, Martha K. ; Aronson, William J. ; Cooperberg, Matthew R. ; Amling, Christopher L. ; Kane, Christopher J. ; Partin, Alan Wayne ; Han, Misop ; Freedland, Stephen J. / Is clinical stage T2c prostate cancer an intermediate- or high-risk disease?. In: Cancer. 2015 ; Vol. 121, No. 9. pp. 1414-1421.
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abstract = "Background Clinical stage T2c (cT2c) is an indeterminate factor in prostate cancer (PC) risk stratification. According to the D'Amico grouping and American Urological Association guidelines, cT2c is a high risk, whereas the National Comprehensive Cancer Network and the European Urological Association classify cT2c as an intermediate risk. This study assessed whether cT2c tumors without other high-risk factors (clinical stage T2c, not otherwise specified [cT2c-NOS]) behaved as an intermediate or high risk through an analysis of biochemical recurrence (BCR) after radical prostatectomy. Methods Two thousand seven hundred fifty-nine men from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database and 12,900 men from Johns Hopkins Hospital (JHH) from 1988-2011 and 1982-2012, respectively, were analyzed. Patients were grouped into low-risk (prostate-specific antigen [PSA] <10 ng/mL, Gleason sum ≤ 6, and cT1-T2a), intermediate-risk (PSA = 10-20 ng/mL, Gleason sum = 7, or cT2b), and high-risk PC categories (PSA > 20 ng/mL, Gleason sum = 8-10, or cT3). Men with cT2c tumors who were not otherwise at high risk (ie, PSA<20 ng/mL and Gleason sum <8) were placed into a separate category termed cT2c-NOS. Associations between cT2c-NOS and intermediate- and high-risk patients and BCR were tested with the log-rank test and Cox proportional analysis models. Results Ninety-nine men (4{\%}) from SEARCH and 202 men (2{\%}) from JHH had tumors classified as cT2c-NOS. The cT2c-NOS patients had a BCR risk similar to that of the intermediate-risk patients (SEARCH, P =.27; JHH, P =.23) but a significantly lower BCR risk in comparison with the high-risk patients (SEARCH, P",
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AU - Klaassen, Zachary

AU - Singh, Abhay A.

AU - Howard, Lauren E.

AU - Feng, Zhaoyong

AU - Trock, Bruce

AU - Terris, Martha K.

AU - Aronson, William J.

AU - Cooperberg, Matthew R.

AU - Amling, Christopher L.

AU - Kane, Christopher J.

AU - Partin, Alan Wayne

AU - Han, Misop

AU - Freedland, Stephen J.

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N2 - Background Clinical stage T2c (cT2c) is an indeterminate factor in prostate cancer (PC) risk stratification. According to the D'Amico grouping and American Urological Association guidelines, cT2c is a high risk, whereas the National Comprehensive Cancer Network and the European Urological Association classify cT2c as an intermediate risk. This study assessed whether cT2c tumors without other high-risk factors (clinical stage T2c, not otherwise specified [cT2c-NOS]) behaved as an intermediate or high risk through an analysis of biochemical recurrence (BCR) after radical prostatectomy. Methods Two thousand seven hundred fifty-nine men from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database and 12,900 men from Johns Hopkins Hospital (JHH) from 1988-2011 and 1982-2012, respectively, were analyzed. Patients were grouped into low-risk (prostate-specific antigen [PSA] <10 ng/mL, Gleason sum ≤ 6, and cT1-T2a), intermediate-risk (PSA = 10-20 ng/mL, Gleason sum = 7, or cT2b), and high-risk PC categories (PSA > 20 ng/mL, Gleason sum = 8-10, or cT3). Men with cT2c tumors who were not otherwise at high risk (ie, PSA<20 ng/mL and Gleason sum <8) were placed into a separate category termed cT2c-NOS. Associations between cT2c-NOS and intermediate- and high-risk patients and BCR were tested with the log-rank test and Cox proportional analysis models. Results Ninety-nine men (4%) from SEARCH and 202 men (2%) from JHH had tumors classified as cT2c-NOS. The cT2c-NOS patients had a BCR risk similar to that of the intermediate-risk patients (SEARCH, P =.27; JHH, P =.23) but a significantly lower BCR risk in comparison with the high-risk patients (SEARCH, P

AB - Background Clinical stage T2c (cT2c) is an indeterminate factor in prostate cancer (PC) risk stratification. According to the D'Amico grouping and American Urological Association guidelines, cT2c is a high risk, whereas the National Comprehensive Cancer Network and the European Urological Association classify cT2c as an intermediate risk. This study assessed whether cT2c tumors without other high-risk factors (clinical stage T2c, not otherwise specified [cT2c-NOS]) behaved as an intermediate or high risk through an analysis of biochemical recurrence (BCR) after radical prostatectomy. Methods Two thousand seven hundred fifty-nine men from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database and 12,900 men from Johns Hopkins Hospital (JHH) from 1988-2011 and 1982-2012, respectively, were analyzed. Patients were grouped into low-risk (prostate-specific antigen [PSA] <10 ng/mL, Gleason sum ≤ 6, and cT1-T2a), intermediate-risk (PSA = 10-20 ng/mL, Gleason sum = 7, or cT2b), and high-risk PC categories (PSA > 20 ng/mL, Gleason sum = 8-10, or cT3). Men with cT2c tumors who were not otherwise at high risk (ie, PSA<20 ng/mL and Gleason sum <8) were placed into a separate category termed cT2c-NOS. Associations between cT2c-NOS and intermediate- and high-risk patients and BCR were tested with the log-rank test and Cox proportional analysis models. Results Ninety-nine men (4%) from SEARCH and 202 men (2%) from JHH had tumors classified as cT2c-NOS. The cT2c-NOS patients had a BCR risk similar to that of the intermediate-risk patients (SEARCH, P =.27; JHH, P =.23) but a significantly lower BCR risk in comparison with the high-risk patients (SEARCH, P

KW - biochemical recurrence

KW - clinical staging

KW - D'Amico risk stratification

KW - Gleason score

KW - prostate cancer

KW - prostate-specific antigen

KW - radical prostatectomy

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