Clinical staging of prostate cancer: Reproducibility and clarification of issues

Timothy Campbell, John Blasko, E. David Crawford, Jeffrey Forman, Gerald Hanks, Deborah Kuban, James Montie, Judd Moul, Alan Pollack, Derek Raghavan, Paul Ray, I. I I Mack Roach, Gary Steinberg, Nelson Stone, Ian Thompson, Nicholas Vogelzang, Srinivasan Vijayakumar

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The American Joint Committee on Cancer (AJCC) staging system for prostate cancer adopted in 1992 is based on tumor-node-metastasis (TNM) designations. It has been widely accepted for use in local and advanced disease. The purpose of this study was to assess reproducibility of staging among observers and to help clarify staging issues. Twelve prostate cancer cases were sent to 20 physicians with special expertise in prostate cancer including eight urologists, eight radiation oncologists, and four medical oncologists. Physicians were asked to assign a stage based on the 1992 AJCC clinical staging. The most frequently reported stage assigned to each case was taken to be the consensus. Agreement was the percentage of physicians who reported that particular stage. Seventy-five percent of the physicians responded. The overall agreement for assignment oft stage was 63.9%. Differences were found by specialty for inclusion of available information in designating a T stage. The overall agreement for N stage was 73.8%. The most common designation was Nx regardless of availability of a computed tomography scan. The overall agreement for M stage was 76.6%. Without a bone scan the most common designation was Mx regardless of Gleason grade or prostate-specific antigen (PSA). A frequent comment was that PSA was more indicative of disease extent than current clinical staging. The reproducibility of the 1992 clinical AJCC staging is poor even among experts in the field. This problem arises primarily from disagreement regarding which studies are included in assigning a stage. Some of these difficulties are addressed in the 1997 revision. However, the clinical staging does not address the true biological significance of disease in many instances.

Original languageEnglish
Pages (from-to)198-209
Number of pages12
JournalInternational Journal of Cancer
Volume96
Issue number3
DOIs
StatePublished - Jun 20 2001
Externally publishedYes

Fingerprint

Neoplasm Staging
Prostatic Neoplasms
Physicians
Prostate-Specific Antigen
Tomography
Neoplasm Metastasis
Bone and Bones
Neoplasms

Keywords

  • Cancer staging
  • Prostate cancer
  • Tumor-node-metastasis (TNM)

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Campbell, T., Blasko, J., David Crawford, E., Forman, J., Hanks, G., Kuban, D., ... Vijayakumar, S. (2001). Clinical staging of prostate cancer: Reproducibility and clarification of issues. International Journal of Cancer, 96(3), 198-209. https://doi.org/10.1002/ijc.1017

Clinical staging of prostate cancer : Reproducibility and clarification of issues. / Campbell, Timothy; Blasko, John; David Crawford, E.; Forman, Jeffrey; Hanks, Gerald; Kuban, Deborah; Montie, James; Moul, Judd; Pollack, Alan; Raghavan, Derek; Ray, Paul; Mack Roach, I. I I; Steinberg, Gary; Stone, Nelson; Thompson, Ian; Vogelzang, Nicholas; Vijayakumar, Srinivasan.

In: International Journal of Cancer, Vol. 96, No. 3, 20.06.2001, p. 198-209.

Research output: Contribution to journalArticle

Campbell, T, Blasko, J, David Crawford, E, Forman, J, Hanks, G, Kuban, D, Montie, J, Moul, J, Pollack, A, Raghavan, D, Ray, P, Mack Roach, III, Steinberg, G, Stone, N, Thompson, I, Vogelzang, N & Vijayakumar, S 2001, 'Clinical staging of prostate cancer: Reproducibility and clarification of issues', International Journal of Cancer, vol. 96, no. 3, pp. 198-209. https://doi.org/10.1002/ijc.1017
Campbell T, Blasko J, David Crawford E, Forman J, Hanks G, Kuban D et al. Clinical staging of prostate cancer: Reproducibility and clarification of issues. International Journal of Cancer. 2001 Jun 20;96(3):198-209. https://doi.org/10.1002/ijc.1017
Campbell, Timothy ; Blasko, John ; David Crawford, E. ; Forman, Jeffrey ; Hanks, Gerald ; Kuban, Deborah ; Montie, James ; Moul, Judd ; Pollack, Alan ; Raghavan, Derek ; Ray, Paul ; Mack Roach, I. I I ; Steinberg, Gary ; Stone, Nelson ; Thompson, Ian ; Vogelzang, Nicholas ; Vijayakumar, Srinivasan. / Clinical staging of prostate cancer : Reproducibility and clarification of issues. In: International Journal of Cancer. 2001 ; Vol. 96, No. 3. pp. 198-209.
@article{a1ccd537422440b3b7fb38f2354d24ab,
title = "Clinical staging of prostate cancer: Reproducibility and clarification of issues",
abstract = "The American Joint Committee on Cancer (AJCC) staging system for prostate cancer adopted in 1992 is based on tumor-node-metastasis (TNM) designations. It has been widely accepted for use in local and advanced disease. The purpose of this study was to assess reproducibility of staging among observers and to help clarify staging issues. Twelve prostate cancer cases were sent to 20 physicians with special expertise in prostate cancer including eight urologists, eight radiation oncologists, and four medical oncologists. Physicians were asked to assign a stage based on the 1992 AJCC clinical staging. The most frequently reported stage assigned to each case was taken to be the consensus. Agreement was the percentage of physicians who reported that particular stage. Seventy-five percent of the physicians responded. The overall agreement for assignment oft stage was 63.9{\%}. Differences were found by specialty for inclusion of available information in designating a T stage. The overall agreement for N stage was 73.8{\%}. The most common designation was Nx regardless of availability of a computed tomography scan. The overall agreement for M stage was 76.6{\%}. Without a bone scan the most common designation was Mx regardless of Gleason grade or prostate-specific antigen (PSA). A frequent comment was that PSA was more indicative of disease extent than current clinical staging. The reproducibility of the 1992 clinical AJCC staging is poor even among experts in the field. This problem arises primarily from disagreement regarding which studies are included in assigning a stage. Some of these difficulties are addressed in the 1997 revision. However, the clinical staging does not address the true biological significance of disease in many instances.",
keywords = "Cancer staging, Prostate cancer, Tumor-node-metastasis (TNM)",
author = "Timothy Campbell and John Blasko and {David Crawford}, E. and Jeffrey Forman and Gerald Hanks and Deborah Kuban and James Montie and Judd Moul and Alan Pollack and Derek Raghavan and Paul Ray and {Mack Roach}, {I. I I} and Gary Steinberg and Nelson Stone and Ian Thompson and Nicholas Vogelzang and Srinivasan Vijayakumar",
year = "2001",
month = "6",
day = "20",
doi = "10.1002/ijc.1017",
language = "English",
volume = "96",
pages = "198--209",
journal = "International Journal of Cancer",
issn = "0020-7136",
publisher = "Wiley-Liss Inc.",
number = "3",

}

TY - JOUR

T1 - Clinical staging of prostate cancer

T2 - Reproducibility and clarification of issues

AU - Campbell, Timothy

AU - Blasko, John

AU - David Crawford, E.

AU - Forman, Jeffrey

AU - Hanks, Gerald

AU - Kuban, Deborah

AU - Montie, James

AU - Moul, Judd

AU - Pollack, Alan

AU - Raghavan, Derek

AU - Ray, Paul

AU - Mack Roach, I. I I

AU - Steinberg, Gary

AU - Stone, Nelson

AU - Thompson, Ian

AU - Vogelzang, Nicholas

AU - Vijayakumar, Srinivasan

PY - 2001/6/20

Y1 - 2001/6/20

N2 - The American Joint Committee on Cancer (AJCC) staging system for prostate cancer adopted in 1992 is based on tumor-node-metastasis (TNM) designations. It has been widely accepted for use in local and advanced disease. The purpose of this study was to assess reproducibility of staging among observers and to help clarify staging issues. Twelve prostate cancer cases were sent to 20 physicians with special expertise in prostate cancer including eight urologists, eight radiation oncologists, and four medical oncologists. Physicians were asked to assign a stage based on the 1992 AJCC clinical staging. The most frequently reported stage assigned to each case was taken to be the consensus. Agreement was the percentage of physicians who reported that particular stage. Seventy-five percent of the physicians responded. The overall agreement for assignment oft stage was 63.9%. Differences were found by specialty for inclusion of available information in designating a T stage. The overall agreement for N stage was 73.8%. The most common designation was Nx regardless of availability of a computed tomography scan. The overall agreement for M stage was 76.6%. Without a bone scan the most common designation was Mx regardless of Gleason grade or prostate-specific antigen (PSA). A frequent comment was that PSA was more indicative of disease extent than current clinical staging. The reproducibility of the 1992 clinical AJCC staging is poor even among experts in the field. This problem arises primarily from disagreement regarding which studies are included in assigning a stage. Some of these difficulties are addressed in the 1997 revision. However, the clinical staging does not address the true biological significance of disease in many instances.

AB - The American Joint Committee on Cancer (AJCC) staging system for prostate cancer adopted in 1992 is based on tumor-node-metastasis (TNM) designations. It has been widely accepted for use in local and advanced disease. The purpose of this study was to assess reproducibility of staging among observers and to help clarify staging issues. Twelve prostate cancer cases were sent to 20 physicians with special expertise in prostate cancer including eight urologists, eight radiation oncologists, and four medical oncologists. Physicians were asked to assign a stage based on the 1992 AJCC clinical staging. The most frequently reported stage assigned to each case was taken to be the consensus. Agreement was the percentage of physicians who reported that particular stage. Seventy-five percent of the physicians responded. The overall agreement for assignment oft stage was 63.9%. Differences were found by specialty for inclusion of available information in designating a T stage. The overall agreement for N stage was 73.8%. The most common designation was Nx regardless of availability of a computed tomography scan. The overall agreement for M stage was 76.6%. Without a bone scan the most common designation was Mx regardless of Gleason grade or prostate-specific antigen (PSA). A frequent comment was that PSA was more indicative of disease extent than current clinical staging. The reproducibility of the 1992 clinical AJCC staging is poor even among experts in the field. This problem arises primarily from disagreement regarding which studies are included in assigning a stage. Some of these difficulties are addressed in the 1997 revision. However, the clinical staging does not address the true biological significance of disease in many instances.

KW - Cancer staging

KW - Prostate cancer

KW - Tumor-node-metastasis (TNM)

UR - http://www.scopus.com/inward/record.url?scp=0035919238&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035919238&partnerID=8YFLogxK

U2 - 10.1002/ijc.1017

DO - 10.1002/ijc.1017

M3 - Article

C2 - 11410889

AN - SCOPUS:0035919238

VL - 96

SP - 198

EP - 209

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 3

ER -