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Question regarding Walsh book Partin Table

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Posted 5/7/2017 7:15 PM (GMT -5)
I'm trying to understand the Partin table while reading Walsh's book.
How would I interpret a T2c with PSA of 4.4 and Gleason 3+3=6? What is the table telling me? Thanks for any help.
Posted 5/7/2017 8:17 PM (GMT -5)
Well you have a low PSA and a low Gleason score, so that is good. I am guessing that those numbers come from your biopsy. If I understand the Partin table, it would look at those factors after treatment and if you have a recurrence of PCA it would look at the doubling time of your PSA. Unless you have a higher Gleason score, say after surgery, you still have good stats. Some of the pro's will chime it later.
Michael
Posted 5/7/2017 8:42 PM (GMT -5)
It's the statistical odds of what a post-operative pathology report would say about your prostate cancer.

You should be looking at the table titled:

CLINICAL STAGE T2B (PALPABLE ON MORE THAN HALF OF ONE LOBE) OR T2C (PALPABLE ON BOTH LOBES)

Read to the right of your PSA range....

4.1-6.0

The likelihood of an after surgery pathology report (pathological stage) of the following are:

Organ Confined 66%
Extraprostatic extension 30%
Seminal vesicle (involvement) 4%
Lymph Node (involvement) 1%

A man with your numbers and staging can expect the above to occur.

That's called a "nomogram". Here is another one for you to look at....

/www.mskcc.org/nomograms/prostate/pre-op

Have you had a urologist (or more than one) tell you that they could feel palpable masses on both sides of your prostate after a DRE?

Post Edited (island time) : 5/7/2017 7:57:20 PM (GMT-6)

Posted 5/7/2017 11:03 PM (GMT -5)
My urologist and every PCP I've had have never felt anything during a DRE. My 12 core biopsy showed 3 positive cores with RL Base 5%, Left Mid 20%, LL Apex 5%. So this appears to be on both sides. My clinical t category would be T2c since it's on both sides. I'll look into your other link. Thanks for your explanation.
Posted 5/8/2017 12:58 PM (GMT -5)
ejc61-

Your interpretation of staging is incorrect. Staging is not based on biopsy findings - only on the DRE. If they felt nothing (as is usually the case), you are stage T1c.
Posted 5/8/2017 2:37 PM (GMT -5)
Thanks Tall Allen. I was trying to interpret the AJCC TNM staging system (clinical stage) from the America Cancer Society website. It reads "The clinical stage is your doctor's best estimate of the extent of your disease, based on the results of the physical exam (including DRE), lab tests, prostate biopsy, and any imaging tests you have had." A bit confusing because I couldn't determine if T1c or T2c. He thinks I'm good for AS but I'm also having the slides sent to JH Epstein lab.

Post Edited (ejc61) : 5/8/2017 1:40:45 PM (GMT-6)

Posted 5/8/2017 2:43 PM (GMT -5)
Here's an article about it. They are revising it slightly to make it more clear. In the 7th edition, physicians were allowed to use imaging (but not biopsies) for staging. In the 8th edition, it's DRE only.

/pcnrv.blogspot.com/2017/03/prostate-cancer-staging-update.html
Posted 5/8/2017 2:53 PM (GMT -5)
Wow thanks TA.
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