New model helps predict chance of surgical cure for prostate cancer
9 January 2012
Prostate cancer experts at Johns Hopkins Hospital in the US
have developed an updated version of a statistical model, called the
Partin Tables, which helps assess the chance of a surgical cure for men
diagnosed with prostate cancer.
The updated tool, based on a study of more than 5,600 men treated at
The Johns Hopkins Hospital from 2006 to 2011, is published in the
Jan 3 issue of the British Journal of Urology International.
“The first thing most men want to know when they learn they have
prostate cancer is their prognosis — whether it can be cured,” says
Alan W Partin, MD PhD, professor and director of Urology at the
Johns Hopkins University School of Medicine, and creator of the
Partin Tables. “The Partin Tables are a statistical model to show
the probability that the cancer is confined to the prostate and
therefore is likely to be cured with surgery,” he says.
The model is based on a patient’s prostate specific antigen (PSA)
level, Gleason Score (a number from 2 to 10 that estimates the
aggressiveness of tumours removed during a biopsy based on their
appearance under a microscope), and clinical stage — the extent to
which a tumour can be felt during a digital exam.
Treatment decisions for prostate cancer are very complex and
depend on a variety of factors, including whether the cancer is
confined to the prostate or whether it has spread to the edge of the
gland, seminal vesicles, lymph nodes or elsewhere in the body. Data
for the Partin Tables, first published in 1993, have been based on
the outcomes for more than 20,000 men who underwent prostate removal
(known as radical prostatectomy) at Johns Hopkins over the past
three decades. This represents the third update of the data.
“Twenty years ago, before widespread adoption of PSA for early
detection, many men were diagnosed with prostate cancer after their
cancer had spread. Today, the vast majority of men are diagnosed
when the cancer is still confined to the prostate, giving them a
much better chance of a cure with a surgical removal of the
prostate,” says Partin.
John B Eifler MD, the lead author of the article who worked with
Partin on the revision, says the new Partin Tables show that certain
categories of men who were previously not thought to have a good
prognosis actually could be cured with surgery. “We now have a
better understanding of intermediate risk and see that more men now
fall into that category, instead of the higher risk group,” says
For example, men with a biopsy Gleason Score of 8 and above
previously were not thought to be good candidates for surgery
because of the likelihood that the cancer had spread. The new data
show a higher probability of a cure with surgery even if a man’s
Gleason score is 8. Scores of 9 and 10 are still considered high
risk, indicating that the cancer likely has spread.
The researchers also found that having a PSA level of 10 and
above was a better cut-off for predicting the spread of disease
compared to lower levels.
“The updated Partin Tables will significantly improve the ability
of physicians to counsel patients on the extent of their disease and
help them make treatment decisions, such as whether surgery is
warranted and, if so, whether lymph nodes also should be removed
during surgery,” Partin says. “If there is a high probability that
the cancer has spread, treatment options include radiation,
chemotherapy and hormonal therapy.”
To access the updated Partin Tables, go to
By inputting the PSA, the Gleason Score and the clinical stage
results, and clicking on “find results,” an individual can see the
percentage chance that the cancer is confined to the prostate, has
migrated to the edge of the gland, has invaded the seminal vesicles
or has spread to the lymph nodes.