New Test Can Provide A More Accurate Prognosis For Prostate Cancer Patients
Men diagnosed with prostate cancer can be provided with a more accurate prognosis of their risk of death from the disease, and treatment planned accordingly, according to new research from the University of Cambridge. The study, which was published in PLOS Medicine, used data from 10,139 British men with prostate cancer. From that data, researchers developed a scheme in which men were grouped into five strata with different levels of risk of prostate cancer death, based on straightforward, routinely available, clinical measurements such as prostate specific antigen (PSA) level, disease stage, and tumour grade as judged by biopsy.
Researchers separately analysed two large groups of men – one using the current three-stratum classification system endorsed by most national and international guidelines (including the National Institute for Health and Care Excellence – NICE), and the other using their five-stratum system. They found that over a median follow-up of 6.9 years, the five-stratum system performed better in terms of predicting the risk of cancer death. Lead researcher Dr. Vincent J. Gnanapragasam stated:
“To our knowledge, this study is the first to test the standard three-stratum risk stratification system in an unscreened first diagnosis population and to measure this system’s ability to predict prostate cancer-specific mortality. We show that this model has a poor concordance for predicting mortality outcome at the point of diagnosis and is probably of little value in this context. Our new model performs much better and not only improves prediction of mortality but also provides better distinction of patient subgroups to inform clinical decision making.”
Additionally researchers noted, that because their study was limited by a reliance on cancer registry records and by relatively short follow-up (median 6.9 years), further validation in independent additional cohorts is required. Dr. Gnanapragasam further added that while the findings needed to be validated in a much larger study he said:
“Nevertheless, the large sample size and the consistency of our findings in external validation suggest that these findings are robust and ready for clinical use. The new model does not require any additional variables other than those routinely collected at diagnosis in any clinic setting worldwide and will therefore be simple to adopt internationally.”