ABSTRACT
Central to the choice of definitive therapy for prostate cancer whether surgery, radiation, hormonal, or watchful waiting, is the prediction of tumor stage. Protocols designed to detect possible distant and/or local progression have been standardized. In addition, the 1990s witnessed the development of numerous models or nomograms designed to provide pretherapy prediction of organ containment or extraprostatic extension. Foremost among these nomograms are the ‘Partin Tables’ introduced in 1993 with multiple subsequent revisions and updates.1-4 These nomograms combine the information of: (1) clinical stage determined by digital rectal examination (DRE); (2) serum prostate-specific antigen (PSA) level; and (3) Gleason score of the needle biopsy. The American Brachytherapy Society (ABS) utilizes these same three parameters to form the basis of ‘suitability criteria’ in evaluating patients for this form of definitive therapy.5-8
An analysis of these parameters has repeatedly demonstrated that DRE-determined clinical stage and serum PSA used individually or in combination, have limited discriminatory value. Only the Gleason grade has a measure of objectivity and has proven predictive value.
