Risk for metastasis post-surgery: a prognostic algorithm

A media release issued last Wednesday from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and based on data presented at the recent annual meeting of the American Society for Clinical Oncology (ASCO), is suggesting that it is possible to predict, with greater accuracy, the long-term risk of metastatic disease in men treated surgically for supposedly localized prostate cancer.

The data on which this media release is based were presented at the ASCO meeting by Antonarakis et al., and have been previously discussed on this site. The original abstract of their presentation can be found on the ASCO web site.

The media release is focused on the fact that a combination of three sets of data can be used to assess risk for subsequent metastatic disease in surgically treated patients:

  • PSA doubling time post-surgery
  • Pathologic Gleason score based on the surgical specimen
  • Time from surgery until the PSA rises to 0.2 ng/ml or higher

As previously reported, PSA doubling time appears to be the most critical of these factors, since a PSA doubling time of < 3 months is some 20 times more likely to imply progression to metastatic disease than a PSA value > 15 months.

We hope and assume that the Johns Hopkins Group will make this data available quickly as an on-line prognostic algorithm that can be easily used by patients and their physicians to predict risk for metastasis.

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