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The Tables That Revolutionized Treatment Decision-Making If you're dealing with prostate cancer, you'll hear about Partin tables, which have become a valuable tool for doctors and patients. The tables, developed by urologists Alan W. Partin, M.D., Ph.D., and Patrick C. Walsh, M.D., help doctors and patients decide upon the best course of treatment for prostate cancer. It is difficult for urologists to predict what they might find during radical prostatectomy, surgery to remove the prostate. Surgery can cure prostate cancer only if the disease has not spread too far beyond the confines of the prostate. Before the Partin tables were developed, doctors could guess the extent of cancer spread, but they couldn't be sure until they examined the patient's pelvic lymph nodes in a procedure called pelvic lymph-node dissection. And even then, microscopic bits of cancer, too small to be seen, could have strayed beyond the prostate. Drs. Partin and Walsh correlated three elements doctors are able to determine about a man's prostate cancer — PSA level, Gleason score and estimated clinical stage. Using these variables, they devised tables that provide a more accurate means of estimating, before surgery, the likelihood that the cancer had spread to the seminal vesicles, the pelvic lymph nodes or through the prostatic capsule. It is known that men whose cancer involves either the seminal vesicles or the pelvic lymph nodes rarely are cured by surgery. Having an accurate prediction of such involvement can help predict whether the surgery or radiation is likely to be successful. However, it is important to note that while the Partin tables help predict what the surgeon will find during surgery, they have not been demonstrated to predict whether surgery will cure the patient. Let's look at an example of how the Partin tables work. Suppose a man has a PSA of 7, a clinical stage T2 (a lump on one side of the prostate that can be felt during a digital rectal exam) and a Gleason score of 6. By looking up these three variables on the Partin tables, you would estimate that the man has a 50 percent chance of having disease confined to the prostate. A man with a PSA of 24, clinical stage T2a disease and a Gleason score of 7 has only an 11-percent chance of having organ-confined disease, with a 23-percent chance of having positive seminal vesicles.
Last updated March 09, 2004
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