2007 Partin Tables
Show the Increasing Curability of Prostate Cancer
Good news: The Partin Tables have changed. Even better news: They had to change, to reflect the sharp decrease in men being diagnosed with later-stage, more advanced cancer.
The Tables, which use a man’s Gleason score, his PSA, and clinical stage (determined by his prostate biopsy), are used by millions of men worldwide as “virtual surgery” — the next best thing to knowing what would be found if the prostate were removed surgically and examined by a pathologist. They provide an excellent way to predict a man’s chances of cure — his chances that treatment will eliminate the disease forever, and that no cancer cells have escaped the prostate.
Originally developed in 1993 by Alan W. Partin, M.D., Ph.D., and Patrick C . Walsh, M.D., after Partin studied the course of prostate cancer in hundreds of Walsh’s radical prostatectomy patients, the Tables have gotten bigger, better, and increasingly hopeful over the years. The 2007 Tables are based on the results of 5,730 men who underwent surgery at The Johns Hopkins Hospital between 2000 and 2005. “There has been a dramatic shift in clinical stage of men being diagnosed with prostate cancer,” says Partin, Director of Urology and the David Hall McConnell Professor. “Men are being diagnosed at a younger age — which means that they’re starting prostate cancer screening earlier — and the overwhelming majority are now being diagnosed with local or regional disease.” The results of the latest study were published in the June 2007 issue of Urology. “The original tables were based on our institutional experience from an era when few patients were diagnosed with screen-detected prostate cancer,” comments collaborating scientist Dan Makarov. “Therefore, the older versions tended to paint a bleaker prognosis.”
The Tables have gotten bigger, better,
and more hopeful over the years.
In fact, so many of the men studied for these latest Tables had early-stage, organconfined cancer, that Partin and colleagues decided to combine stages T2b and T2c (cancer that is big enough to be felt, involving more than half of one or both lobes, respectively). “From our very first Tables to these latest nomograms, there has been a decline in palpable disease from 86 percent to 23 percent,” says Partin. Even men with high Gleason scores (Gleason 8 to 10) tended to be diagnosed with more curable cancer, because it’s being detected earlier.
Note: The tables only include men who underwent surgery, and for this reason in men with Gleason 8-10 disease, the predictions only apply to a bestcase scenario, of a few carefully selected men, with limited high-grade disease on their biopsies.