RISK ASSESSMENT AND ALGORITHMS
The Partin Tables
The Partin Tables represent one of the many algorithms that can help to establish probabilities as to the extent of progression of prostate cancer. In 1993, Dr. Alan Partin, et al1 examined medical records of 703 patients with clinically localized disease who underwent a radical prostatectomy between 1982 and 1991. They compared pre-operative findings for: (1) the serum PSA, (2) the Gleason score and (3) the clinical stage with post-surgical findings of organ-confined disease (OCD), extraprostatic extension, seminal vesicle invasion and lymph node invasion. Using this data, they developed a model that could help predict the pathological stage in a newly diagnosed patient with clinically localized PC.
In 2001, the Partin Tables were updated2 based on a larger series of 5079 men treated with prostatectomy (without neoadjuvant therapy) between 1994 and 2000 at Johns Hopkins Hospital. The mean follow-up was 6.3 years after surgery. All patients were defined as having clinically localized prostate cancer. There was a noted shift in trend of disease characteristics, with more men presenting with Clinical Stage T1c, Gleason score 5 to 6, and serum PSA levels below 10.0 ng/mL.
Patients can use the Partin Tables with the following 3 pieces of personal information:
to determine a representative probability of:
1) organ-confined disease
2) extraprostatic extension
3) seminal vesicle invasion
4) pelvic lymph node invasion
The 2001 Partin Tables and an interactive calculator are available on the John Hopkins Brady Urological Institute Web site.
The primary value of the updated Partin Tables is for “counseling patients regarding the probability of their tumor being a specific pathologic stage, rather than a strict decision-making tool”. The tables may help a patient determine whether it is advisable to undergo definitive local therapy in the hopes of curing his cancer. Results from the tables may also suggest the patient consider further laboratory, radiological or pathological testing to attempt to determine if the cancer has spread beyond the prostate gland.
- The tables are based on the results from a single institution which is highly regarded for both Urology and Pathology. For reliable comparison, the Digital Rectal Exam and the Gleason Score should be determined by physicians with a similar level of expertise.
- The Johns Hopkins patient population was primarily Caucasian and the results have not been verified for an African-American population
- Algorithms give probabilities of treatment success, based on scientific studies done with hundreds or thousands of patients. While these may provide some guidance, remember that they are not based on treatments using current technology. Software for the Partin Tables, and other algorithms, can found as part of PC Tools II in the Software section of www.pcri.org. The PCRI Helpline staff can calculate these algorithms for you but must disclaim responsibility for the accuracy or any subsequent use of the results. You should discuss these with your own physicians.
1. Partin AW, Yoo J, Carter HB, Pearson JD, Chan DW, Epstein JI, Walsh PC. The use of prostate specific antigen, clinical stage, and Gleason Score to predict pathological stage in men with localized prostate cancer. J Urol 150:110-14, 1993.
2. Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD. Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium. Urology 58:843-8, 2001