The T classification of clinically localized prostate cancer: An appraisal based on disease outcome after radiation therapy

G. K. Zagars, F. B. Geara, Alan Pollack, A. C. Von Eschenbach

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background. This study was performed to evaluate the use of the 1992 International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) T categories for localized prostate cancer treated with radiation therapy and to compare the prognostic power of this system with the Whitmore- Jewett scheme. Methods. The outcome for 427 men with Stages A2-C or T1a-T4b prostate cancers, followed for a mean of 32 months after treatment, was evaluated for relapse or rising prostate-specific antigen (PSA) levels, disease relapse, metastatic failure, and local recurrence relative to the two staging systems. Univariate and multivariate analysis was used to compare the two staging systems. The T categories were based on digital rectal examination. Results. At 5 years, the actuarial incidence of relapse or rising PSA level was as follows: Stage A2, 29%; Stage B, 41%; Stage C, 62%. The corresponding results according to T category were as follows: T1a, 0%; T1b, 37%; T1c, 23%; T2a, 39%; T2b, 38%; T2c, 42%; T3a, 53%; T3c, 68%; T4b, greater than 75%. Too few patients were in the T3b and T4a categories. The following five-category grouping was significantly superior prognostically to the Whitmore-Jewett system: T1a, T1c, T1b/T2, T3, T4. The actuarial incidences of relapse or rising PSA at 5 years were as follows: T1a, 0%; T1c, 23%; T1b/T2, 41%; T3, 61%; and T4, 75%. No differences were evident within the T2 or T3 categories. Conclusions. The current UICC/AJCC system appears to be a valid method for categorizing a primary prostate carcinoma. This system defines a greater number of meaningful tumor categories and is prognostically superior to the traditional Whitmore-Jewett scheme.

Original languageEnglish
Pages (from-to)1904-1912
Number of pages9
JournalCancer
Volume73
Issue number7
StatePublished - Jan 1 1994
Externally publishedYes

Fingerprint

Prostatic Neoplasms
Radiotherapy
Recurrence
Prostate-Specific Antigen
varespladib methyl
Neoplasms
Digital Rectal Examination
Incidence
Prostate
Multivariate Analysis
Carcinoma
Therapeutics

Keywords

  • prostate cancer
  • prostate-specific antigen
  • radiation therapy
  • staging
  • TNM system

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

The T classification of clinically localized prostate cancer : An appraisal based on disease outcome after radiation therapy. / Zagars, G. K.; Geara, F. B.; Pollack, Alan; Von Eschenbach, A. C.

In: Cancer, Vol. 73, No. 7, 01.01.1994, p. 1904-1912.

Research output: Contribution to journalArticle

Zagars, G. K. ; Geara, F. B. ; Pollack, Alan ; Von Eschenbach, A. C. / The T classification of clinically localized prostate cancer : An appraisal based on disease outcome after radiation therapy. In: Cancer. 1994 ; Vol. 73, No. 7. pp. 1904-1912.
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title = "The T classification of clinically localized prostate cancer: An appraisal based on disease outcome after radiation therapy",
abstract = "Background. This study was performed to evaluate the use of the 1992 International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) T categories for localized prostate cancer treated with radiation therapy and to compare the prognostic power of this system with the Whitmore- Jewett scheme. Methods. The outcome for 427 men with Stages A2-C or T1a-T4b prostate cancers, followed for a mean of 32 months after treatment, was evaluated for relapse or rising prostate-specific antigen (PSA) levels, disease relapse, metastatic failure, and local recurrence relative to the two staging systems. Univariate and multivariate analysis was used to compare the two staging systems. The T categories were based on digital rectal examination. Results. At 5 years, the actuarial incidence of relapse or rising PSA level was as follows: Stage A2, 29{\%}; Stage B, 41{\%}; Stage C, 62{\%}. The corresponding results according to T category were as follows: T1a, 0{\%}; T1b, 37{\%}; T1c, 23{\%}; T2a, 39{\%}; T2b, 38{\%}; T2c, 42{\%}; T3a, 53{\%}; T3c, 68{\%}; T4b, greater than 75{\%}. Too few patients were in the T3b and T4a categories. The following five-category grouping was significantly superior prognostically to the Whitmore-Jewett system: T1a, T1c, T1b/T2, T3, T4. The actuarial incidences of relapse or rising PSA at 5 years were as follows: T1a, 0{\%}; T1c, 23{\%}; T1b/T2, 41{\%}; T3, 61{\%}; and T4, 75{\%}. No differences were evident within the T2 or T3 categories. Conclusions. The current UICC/AJCC system appears to be a valid method for categorizing a primary prostate carcinoma. This system defines a greater number of meaningful tumor categories and is prognostically superior to the traditional Whitmore-Jewett scheme.",
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T1 - The T classification of clinically localized prostate cancer

T2 - An appraisal based on disease outcome after radiation therapy

AU - Zagars, G. K.

AU - Geara, F. B.

AU - Pollack, Alan

AU - Von Eschenbach, A. C.

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N2 - Background. This study was performed to evaluate the use of the 1992 International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) T categories for localized prostate cancer treated with radiation therapy and to compare the prognostic power of this system with the Whitmore- Jewett scheme. Methods. The outcome for 427 men with Stages A2-C or T1a-T4b prostate cancers, followed for a mean of 32 months after treatment, was evaluated for relapse or rising prostate-specific antigen (PSA) levels, disease relapse, metastatic failure, and local recurrence relative to the two staging systems. Univariate and multivariate analysis was used to compare the two staging systems. The T categories were based on digital rectal examination. Results. At 5 years, the actuarial incidence of relapse or rising PSA level was as follows: Stage A2, 29%; Stage B, 41%; Stage C, 62%. The corresponding results according to T category were as follows: T1a, 0%; T1b, 37%; T1c, 23%; T2a, 39%; T2b, 38%; T2c, 42%; T3a, 53%; T3c, 68%; T4b, greater than 75%. Too few patients were in the T3b and T4a categories. The following five-category grouping was significantly superior prognostically to the Whitmore-Jewett system: T1a, T1c, T1b/T2, T3, T4. The actuarial incidences of relapse or rising PSA at 5 years were as follows: T1a, 0%; T1c, 23%; T1b/T2, 41%; T3, 61%; and T4, 75%. No differences were evident within the T2 or T3 categories. Conclusions. The current UICC/AJCC system appears to be a valid method for categorizing a primary prostate carcinoma. This system defines a greater number of meaningful tumor categories and is prognostically superior to the traditional Whitmore-Jewett scheme.

AB - Background. This study was performed to evaluate the use of the 1992 International Union Against Cancer (UICC)/American Joint Committee on Cancer (AJCC) T categories for localized prostate cancer treated with radiation therapy and to compare the prognostic power of this system with the Whitmore- Jewett scheme. Methods. The outcome for 427 men with Stages A2-C or T1a-T4b prostate cancers, followed for a mean of 32 months after treatment, was evaluated for relapse or rising prostate-specific antigen (PSA) levels, disease relapse, metastatic failure, and local recurrence relative to the two staging systems. Univariate and multivariate analysis was used to compare the two staging systems. The T categories were based on digital rectal examination. Results. At 5 years, the actuarial incidence of relapse or rising PSA level was as follows: Stage A2, 29%; Stage B, 41%; Stage C, 62%. The corresponding results according to T category were as follows: T1a, 0%; T1b, 37%; T1c, 23%; T2a, 39%; T2b, 38%; T2c, 42%; T3a, 53%; T3c, 68%; T4b, greater than 75%. Too few patients were in the T3b and T4a categories. The following five-category grouping was significantly superior prognostically to the Whitmore-Jewett system: T1a, T1c, T1b/T2, T3, T4. The actuarial incidences of relapse or rising PSA at 5 years were as follows: T1a, 0%; T1c, 23%; T1b/T2, 41%; T3, 61%; and T4, 75%. No differences were evident within the T2 or T3 categories. Conclusions. The current UICC/AJCC system appears to be a valid method for categorizing a primary prostate carcinoma. This system defines a greater number of meaningful tumor categories and is prognostically superior to the traditional Whitmore-Jewett scheme.

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