59M, Gleason 4+3=7, PSA7.8,
Clinical diagnosis after biopsy: Prostate cancer cT2cNxMxG3
As I'm doing my research on probability analysis I came across these useful tools from John Hopkins website:
1) Han Tables, Preoperative Model, Postoperative Model to gauge recurrence risk after surgery.
With my data I get this information:
3 years after surgery: 10% (3-30)
5 years after surgery: 16% (5-46)
7 years after surgery: 22% (7-58)
10 years after surgery: 28% (9-68)
Not too bad right? Well, another John Hopkins study says that high risk patients get 80% recurrence after surgery within 15 years. So why the huge difference and which data to believe?
2) Partin tables to predict spread of cancer.
OC: organ confined (20)
EPE: extraprostatic extension (32)
SV+: seminal vesicle involvement (7)
LN+: lymph node involvement (12)
25 (19-31)
44 (36-51)
17 (11-24)
14 (8-22)
This is information website gives me. So it shows that the % of being organ contained is only 25%? If so, doesn't that mean that surgery will most likely NOT take out the whole cancer? So what does that mean in practicality? That radiation is a better choice? And if yes, which radiation? And how expansive should it be?
Also, how is extraprostatic extension different from seminal vesicle involvement and lymph node involvement? Where else outside prostate can it spread?
3) UCSF-CAPRA Score for Prostate Cancer Risk
This puts me at High risk by UCSF-CAPRA. 29-34% disease-free survival at 5 years.
But I'm no doc, so not sure I'm filling everything correctly.
On top of questions above...
4) what other tools do you know that you have found useful for analysis?
5) And where do you get the best statistical information comparing radiation vs surgery side effects % wise?
________________________ 59M, Gleason 4+3, PSA7.8, T2C. DaVinci Surgery in 2021. PSA rising after surgery. What to do next? |
User
59M, Gleason 4+3=7, PSA7.8,
Clinical diagnosis after biopsy: Prostate cancer cT2cNxMxG3
As I'm doing my research on probability analysis I came across these useful tools from John Hopkins website:
1) Han Tables, Preoperative Model, Postoperative Model to gauge recurrence risk after surgery.
With my data I get this information:
3 years after surgery: 10% (3-30)
5 years after surgery: 16% (5-46)
7 years after surgery: 22% (7-58)
10 years after surgery: 28% (9-68)
Not too bad right? Well, another John Hopkins study says that high risk patients get 80% recurrence after surgery within 15 years. So why the huge difference and which data to believe?
2) Partin tables to predict spread of cancer.
OC: organ confined (20)
EPE: extraprostatic extension (32)
SV+: seminal vesicle involvement (7)
LN+: lymph node involvement (12)
25 (19-31)
44 (36-51)
17 (11-24)
14 (8-22)
This is information website gives me. So it shows that the % of being organ contained is only 25%? If so, doesn't that mean that surgery will most likely NOT take out the whole cancer? So what does that mean in practicality? That radiation is a better choice? And if yes, which radiation? And how expansive should it be?
Also, how is extraprostatic extension different from seminal vesicle involvement and lymph node involvement? Where else outside prostate can it spread?
3) UCSF-CAPRA Score for Prostate Cancer Risk
This puts me at High risk by UCSF-CAPRA. 29-34% disease-free survival at 5 years.
But I'm no doc, so not sure I'm filling everything correctly.
On top of questions above...
4) what other tools do you know that you have found useful for analysis?
5) And where do you get the best statistical information comparing radiation vs surgery side effects % wise?
________________________ 59M, Gleason 4+3, PSA7.8, T2C. DaVinci Surgery in 2021. PSA rising after surgery. What to do next? |
User
I am a great fan of statistics, and I like playing with tools to predict my time of death. BTW these tools are called nomograms you put in details about your diagnosis and it outputs some information such as probability of disease spread, or probability of death at a certain age. You seem to be pretty good at finding them on the Internet. I like https://prostate.predict.nhs.uk/
None of them are as specific as I would like, or you would like. I think the reason is that there is just so much diversity in outcomes even for the same diagnosis, and treatment that it is pointless for the tool to give an exact answer as no one will actually have that outcome.
The NHS one above doesn't even distinguish between surgery and radiation.
|
User
Yes it becomes something like averaging out that each couple having 2.5 children or whatever the figure is, so in reality it could be anything between none to 10 or in a few cases even more so you could be anywhere on the PCa scale. Remember too that among other variables, when it comes to PCa there are a number of different types, some of which are more radio resistant or different in other ways. Even consultants who have years of experience can make wrong predictions and can be surprised by the way men respond to treatment and may vary treatment as they believe is appropriate depending on patient reaction, particularly further down the line.
Barry |
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User
I am a great fan of statistics, and I like playing with tools to predict my time of death. BTW these tools are called nomograms you put in details about your diagnosis and it outputs some information such as probability of disease spread, or probability of death at a certain age. You seem to be pretty good at finding them on the Internet. I like https://prostate.predict.nhs.uk/
None of them are as specific as I would like, or you would like. I think the reason is that there is just so much diversity in outcomes even for the same diagnosis, and treatment that it is pointless for the tool to give an exact answer as no one will actually have that outcome.
The NHS one above doesn't even distinguish between surgery and radiation.
|
User
Yes it becomes something like averaging out that each couple having 2.5 children or whatever the figure is, so in reality it could be anything between none to 10 or in a few cases even more so you could be anywhere on the PCa scale. Remember too that among other variables, when it comes to PCa there are a number of different types, some of which are more radio resistant or different in other ways. Even consultants who have years of experience can make wrong predictions and can be surprised by the way men respond to treatment and may vary treatment as they believe is appropriate depending on patient reaction, particularly further down the line.
Barry |
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