For patients with prostate cancer, the Gleason score combined with pathological category (extent of disease) following a radical prostatectomy are factors which appear to most accurately predict the risk for recurrence following surgery, according to a recent article published in the journal Cancer. Patients at a high risk of experiencing a recurrence according to these factors may benefit from novel adjuvant therapies, while patients considered to have a low risk may be spared from unnecessary treatment.

The prostate is a male sex gland that is located between the bladder and the rectum. Prostate cancer is the second leading cause of cancer death in men in the United States. Patients diagnosed with prostate cancer have many treatment options available to them, depending upon the stage, or extent of their disease. Presently, controversy exists regarding the optimal treatment strategy for patients with this disease. As a result treatment decisions need to be individualized, taking into account the age of the patient and the side effects of treatment.

Men with prostate cancer sometimes undergo a radical prostatectomy, a common surgical procedure which involves the removal of the prostate gland. The rate of a cancer recurrence following a radical prostatectomy varies widely. This has prompted researchers to investigate probable variables associated with a patient that may contribute to these large differences in recurrence rates.

Physicians at the MD Anderson Cancer Center recently analyzed variable factors and outcomes of 265 patients undergoing a radical prostatectomy at their institution between 1987-1993. The researchers analyzed preoperative prostate specific antigen (PSA) levels (blood levels of a protein produced by the prostate), Gleason score (aggressiveness of the cancer), ethnicity, age, and 5 subcategories of pathological stratification (extent of cancer). The two contributable factors which most accurately predicted a rise in PSA levels after 48 months included pathological category and Gleason score. By combining these two factors, physicians may be able to identify a patient’s risk of failure following a radical prostatectomy and classify them into one of three groups: low-risk (no greater than 10%), intermediate-risk (between 10% and 30%), and high-risk (greater than 30%).

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Patients with prostate cancer may wish to speak with their physician about their probable risk of recurrence and adjuvant treatment options or the participation in a clinical trial further evaluating risk factors for recurrence. Two sources of information regarding ongoing clinical trials include comprehensive, easy-to-use listing services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (Cancer, Vol 91, No 8, pp 1414-1422, 2001)

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