Predicting Pathological Stage of Localized Prostate Cancer-Reply

Alan W. Partin, MD, PhD; Kirk J. Wojno, MD; Michael W. Kattan, PhD; J. D. Pearson, PhD; Peter T. Scardino, MD; Joseph E. Oesterling, MD; Eric N. P. Subong, MS; Patrick C. Walsh, MD
JAMA. 1997;278(12):981-982. doi:10.1001/jama.1997.03550120041028.
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In Reply.  —Dr Naitoh and colleagues criticized our analysis based on poor correlation between their own clinical and pathological data compared with data we reported for 4133 patients treated at 3 different institutions. In summary, they found that men with tumors having Gleason scores of 6 and 7, clinical stage of T2b, and PSA levels between 4 and 10 ng/mL had a higher likelihood of having organ-confined disease in their series than was reported by the nomograms presented in our work. They report rates of 70% (Gleason score 6) and 50% (Gleason score 7) of organ-confined disease for men within this subgroup, compared with the rate of 38% and 22% for similar patients in our study.We agree with Naitoh and colleagues that patients with capsular penetration can in fact be cured by radical prostatectomy; however, the probability of cure is less than for those men with organ-confined disease. Therefore, predicting organ-confined


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