Clinical stage, prostate-specific antigen and Gleason grade to predict extracapsular disease or nodal metastasis in men with newly diagnosed, previously untreated prostate cancer. A multicenter study. A. Ur. O. Cooperative Group.

Abstract

To draw nomograms for preoperative predictions of extracapsular and of nodal disease based upon preoperative prostate-specific antigen, Gleason grade and clinical stage. The complete charts of 1,738 patients submitted to radical retropubic prostatectomy in 34 Italian urological departments have been reviewed. The correlation between preoperative variables and pathological examination was tested by both univariate and multivariate techniques. Logistic regression analysis with the likelihood ratio chi 2 test was used to predict the pathological features (T > = 3; N+) of a patient for various combinations of preoperative variables. Probability plots were constructed for the prediction of either extracapsular disease or lymph node involvement by the above-mentioned combination of preoperative variables. The obtained probability curves could be useful for patient counselling, for planning a staging laparoscopic lymphadenectomy in high-risk patients and for deciding whether to perform a nerve-sparing prostatectomy.