A multi-center research team has used data from > 7,300 radical prostatectomy patients treated between 2000 and 2005 at two major medical centers to construct a new “2010 Partin nomogram” to improve prediction of pathologic outcomes after radical surgery.
The current Partin tables (last updated in 2007) use pre-surgical total PSA data to categorize patients into five “risk groups” (with PSA levels of 0-2.5, 2.6-4.0, 4.1-6.0, 6.1-10.0 and >10.0 mg/ml). The new “2010 Partin nomogram” is based on the application of the total PSA level as a “continuous” biomarker to allow the development of a ”predictiveness curve” to facilitate more accurate calculation of the risk of a patient for a specific pathologic outcome.
The new nomogram is based on data from 5,730 patients treated at Johns Hopkins Hospital and another 1,646 patients treated at the University Clinic Hamburg-Eppendorf in Germany. All patients received a radical prostatectomy. No patients received any form of neoadjuvant treatment.
Other patient risk factors remain the same, and are based on the patient’s clinical stage T1c, T2a, and T2b/T2c) and biopsy Gleason score (5-6, 3 + 4 = 7, 4 + 3 = 7, 8-10). This information, together with the new PSA “predictiveness curve” can be used to predict probabilities of:
- Organ-confined disease (OC)
- Extraprostatic extension (EPE)
- Seminal vesicle invasion (SV+)
- Lymph node involvement (LN+)
The development of this new Partin nomogram is described in a recent paper by Huang et al. in BJU International. The currently available on-line system for assessing pathologic outcomes is still based on the 2007 Partin tables. We assume that that web site will be updated at some point in the future to take advantage of this revision of the Partin tables to a nomogram-based system. Huang et al. clearly state that this revision will (or at least should) improve the ability of urologists and their patients to make appropriate treatment decisions.