Pre-treatment risk stratification of prostate cancer patients:A critical review

Authors

  • George Rodrigues Department of Radiation Oncology, London Health Sciences Centre, London, ON;
  • Padraig Warde Department of Radiation Medicine, Princess Margaret Hospital, Toronto, ON
  • Tom Pickles Department of Radiation Oncology, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, BC
  • Juanita Crook Department of Radiation Oncology, Centre for the Southern Interior , British Columbia Cancer Agency, Kelowna BC;
  • Michael Brundage Department of Oncology, Queen’s University, and Cancer Centre of Southeastern Ontario, Kingston, ON;
  • Luis Souhami Department of Radiation Oncology, McGill University, Montreal, QC;
  • Himu Lukka Department of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON

DOI:

https://doi.org/10.5489/cuaj.148

Abstract

Introduction:

 

The use of accepted prostate cancer risk stratification

groups based on prostate-specific antigen, T stage and Gleason

score assists in therapeutic treatment decision-making, clinical trial

design and outcome reporting. The utility of integrating novel prognostic

factors into an updated risk stratification schema is an area

of current debate. The purpose of this work is to critically review

the available literature on novel pre-treatment prognostic factors

and alternative prostate cancer risk stratification schema to assess

the feasibility and need for changes to existing risk stratification

systems.

Methods:

 

A systematic literature search was conducted to identify

original research publications and review articles on prognostic factors

and risk stratification in prostate cancer. Search terms included

risk stratification, risk assessment, prostate cancer or neoplasms,

and prognostic factors. Abstracted information was assessed to

draw conclusions regarding the potential utility of changes to existing

risk stratification schema.

Results:

 

The critical review identified three specific clinically relevant

potential changes to the most commonly used three-group

risk stratification system: (1) the creation of a very-low risk category;

(2) the splitting of intermediate-risk into a low- and highintermediate

risk groups; and (3) the clarification of the interface

between intermediate- and high-risk disease. Novel pathological

factors regarding high-grade cancer, subtypes of Gleason score

7 and percentage biopsy cores positive were also identified as

potentially important risk-stratification factors.

Conclusions:

 

Multiple studies of prognostic factors have been performed

to create currently utilized prostate cancer risk stratification

systems. We propose potential changes to existing systems.

Downloads

Download data is not yet available.

Author Biographies

George Rodrigues, Department of Radiation Oncology, London Health Sciences Centre, London, ON;

Department of Radiation Oncology, London Health Sciences Centre, London, ON;

Padraig Warde, Department of Radiation Medicine, Princess Margaret Hospital, Toronto, ON

Department of Radiation Medicine, Princess Margaret Hospital, Toronto, ON;

Tom Pickles, Department of Radiation Oncology, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, BC

Department of Radiation Oncology, Vancouver Cancer

Centre, British Columbia Cancer Agency, Vancouver, BC

Juanita Crook, Department of Radiation Oncology, Centre for the Southern Interior , British Columbia Cancer Agency, Kelowna BC;

Department of Radiation Oncology, Centre for the Southern Interior , British Columbia Cancer Agency, Kelowna BC;

Michael Brundage, Department of Oncology, Queen’s University, and Cancer Centre of Southeastern Ontario, Kingston, ON;

Department of Oncology, Queen’s

University, and Cancer Centre of Southeastern Ontario, Kingston, ON;

Luis Souhami, Department of Radiation Oncology, McGill University, Montreal, QC;

Department of Radiation Oncology, McGill University, Montreal, QC;

Himu Lukka, Department of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON

Department of Radiation Oncology, Juravinski Cancer Centre, Hamilton, ON

Downloads

Published

2012-12-13

How to Cite

Rodrigues, G., Warde, P., Pickles, T., Crook, J., Brundage, M., Souhami, L., & Lukka, H. (2012). Pre-treatment risk stratification of prostate cancer patients:A critical review. Canadian Urological Association Journal, 6(2). https://doi.org/10.5489/cuaj.148

Issue

Vol. 6 No. 2 (2012): CUAJ April

Section

Review

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.