Nomograms to aid in the treatment of prostatic cancer
First Claim
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1. A method for predicting a quantitative probability of recurrence of prostatic cancer following radical prostatectomy in a patient diagnosed as having prostatic cancer comprising the steps of:
- correlating a selected set of preoperative factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by radical prostatectomy with incidence of recurrence of prostatic cancer for each person of said plurality of persons to generate a functional representation of the correlation, wherein said selected set of preoperative factors comprises pretreatment PSA level, combined Gleason grade and clinical stage, wherein said functional representation of the correlation comprises a pretreatment PSA level scale, a clinical stage scale, a combined Gleason grade scale, a points scale, a total points scale, and a predictor scale, and wherein said pretreatment PSA level scale, said clinical stage scale and said combined Gleason grade scale each have values on said scales which can be correlated with values on the points scale, and wherein said total points scale has values which may be correlated with values on the predictor scale;
determining an identical set of preoperative factors for the patient;
matching the patient'"'"'s pretreatment PSA level to a corresponding value on the pretreatment PSA level scale, and determining a first point value from the corresponding value on the points scale;
matching the patient'"'"'s combined Gleason grade to a corresponding value on the combined Gleason grade scale, and determining a second point value from the corresponding value on the points scale;
matching the patient'"'"'s clinical stage to a corresponding value on the clinical stage scale, and determining a third point value from the corresponding value on the points scale;
adding the first, second and third point values together to get a patient total points value;
matching the patient total points value to a corresponding value on the total points scale; and
correlating the corresponding value on the total points scale with a value on the predictor scale to predict the quantitative probability of recurrence of prostatic cancer in the patient following radical prostatectomy.
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Abstract
This invention relates to methods and apparatus for predicting probability of cancer recurrence following radical prostatectomy using predetermined clinical and pathological factors. The invention includes nomograms which can be used preoperatively and postoperatively in patients diagnosed with prostatic adenocarcinoma to aid in selection of an appropriate course of therapy.
22 Citations
32 Claims
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1. A method for predicting a quantitative probability of recurrence of prostatic cancer following radical prostatectomy in a patient diagnosed as having prostatic cancer comprising the steps of:
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correlating a selected set of preoperative factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by radical prostatectomy with incidence of recurrence of prostatic cancer for each person of said plurality of persons to generate a functional representation of the correlation, wherein said selected set of preoperative factors comprises pretreatment PSA level, combined Gleason grade and clinical stage, wherein said functional representation of the correlation comprises a pretreatment PSA level scale, a clinical stage scale, a combined Gleason grade scale, a points scale, a total points scale, and a predictor scale, and wherein said pretreatment PSA level scale, said clinical stage scale and said combined Gleason grade scale each have values on said scales which can be correlated with values on the points scale, and wherein said total points scale has values which may be correlated with values on the predictor scale; determining an identical set of preoperative factors for the patient; matching the patient'"'"'s pretreatment PSA level to a corresponding value on the pretreatment PSA level scale, and determining a first point value from the corresponding value on the points scale; matching the patient'"'"'s combined Gleason grade to a corresponding value on the combined Gleason grade scale, and determining a second point value from the corresponding value on the points scale; matching the patient'"'"'s clinical stage to a corresponding value on the clinical stage scale, and determining a third point value from the corresponding value on the points scale; adding the first, second and third point values together to get a patient total points value; matching the patient total points value to a corresponding value on the total points scale; and correlating the corresponding value on the total points scale with a value on the predictor scale to predict the quantitative probability of recurrence of prostatic cancer in the patient following radical prostatectomy. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A postoperative method for predicting a quantitative probability of recurrence of prostatic cancer in a patient who has previously undergone a radical prostatectomy comprising the steps of:
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correlating a selected set of factors determined for each of a plurality of persons previously diagnosed with prostatic cancer with incidence of recurrence of prostatic cancer for each person of said plurality to generate a functional representation of the correlation, wherein said selected set of factors comprises preoperative PSA level, specimen Gleason sum, prostatic capsular invasion level, surgical margin status, presence of seminal vesicle invasion, and lymph node status, wherein said plurality of persons comprises men having undergone radical prostatectomy, wherein said functional representation of the correlation comprises a preoperative PSA level scale, a specimen Gleason sum scale, a prostatic capsular invasion level scale, a surgical margin status scale, a presence of seminal vesicle invasion scale, a lymph node status scale, a points scale, a total points scale, and a predictor scale, and wherein said preoperative PSA level scale, said specimen Gleason sum scale, said prostatic capsular invasion level scale, said surgical margin status scale, said presence of seminal vesicle invasion scale, and said lymph node status scale each have values on said scales which can be correlated with values on the points scale, and wherein said total points scale has values on said scale which may be correlated with values on the predictor scale; determining an identical set of factors for the patient; matching the patient'"'"'s preoperative PSA level to a corresponding value on the preoperative PSA level scale, and determining a first point value from the corresponding value on the points scale; matching the patient'"'"'s specimen Gleason sum to a corresponding value on the specimen Gleason sum scale, and determining a second point value from the corresponding value on the points scale; matching the patient'"'"'s prostatic capsular invasion level to a corresponding value on the prostatic capsular invasion level scale, and determining a third point value from the corresponding value on the points scale; matching the patient'"'"'s surgical margin status to a corresponding value on the surgical margin status scale, and determining a fourth point value from the corresponding value on the points scale; matching the patient'"'"'s presence of seminal vesicle invasion to a corresponding value on the presence of seminal vesicle invasion scale, and determining a fifth point value from the corresponding value on the points scale; matching the patient'"'"'s lymph node status to a corresponding value on the lymph node status scale, and determining a sixth point value from the corresponding value on the points scale; adding the first, second, third, fourth, fifth and sixth point values together to get a patient total points value; matching the patient total points value to a corresponding value on the total points scale, and correlating the corresponding value on the total points scale with a value on the predictor scale to predict the quantitative probability of recurrence of prostatic cancer for the patient. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22)
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23. An apparatus for predicting a quantitative probability of disease recurrence in a patient with prostatic cancer following a radical prostatectomy, wherein the apparatus comprises:
- a correlation of preoperative factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by radical prostatectomy with incidence of recurrence of prostatic cancer for each person of said plurality of persons wherein said selected set of preoperative factors comprises pretreatment PSA level, combined Gleason grade and clinical stage; and
a means for comparing an identical set of preoperative factors determined from the patient diagnosed as having prostatic cancer to the correlation to predict the quantitative probability of recurrence of prostatic cancer in the patient following radical prostatectomy.
- a correlation of preoperative factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by radical prostatectomy with incidence of recurrence of prostatic cancer for each person of said plurality of persons wherein said selected set of preoperative factors comprises pretreatment PSA level, combined Gleason grade and clinical stage; and
- 24. A nomogram for the graphic representation of a quantitative probability that a patient with prostate cancer will remain free of disease following radical prostatectomy comprising a plurality of scales and a solid support, the plurality of scales being disposed on said support and comprising a pretreatment PSA level scale, a clinical stage scale, a combined Gleason grade in the biopsy scale, a points scale, a total points scale and a predictor scale, wherein said pretreatment PSA level scale, clinical stage scale and combined Gleason grade scale each have values on said scales, and wherein said pretreatment PSA level scale, said clinical stage scale and said combined Gleason grade scale are disposed on said solid support with respect to the points scale so that each of said values on said pretreatment PSA level scale, said clinical stage scale and said Gleason grade scale can be correlated with values on the points scale, and wherein said total points scale has values on said total points scale and wherein said total points scale is disposed on said solid support with respect to the predictor scale so that said values on said total points scale may be correlated with values on the predictor scale, such that the values on the points scale correlating with the patient'"'"'s pretreatment PSA level, combined Gleason grade, and clinical stage can be added together to yield a total points value, and the total points value can be correlated with the predictor scale to predict the quantitative probability of recurrence.
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27. An apparatus for predicting a quantitative probability of disease recurrence in a patient with prostatic cancer following a radical prostatectomy, wherein the apparatus comprises:
- a correlation of clinical and pathological factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by radical prostatectomy with incidence of recurrence of prostatic cancer for each person of said plurality of persons wherein said selected set of factors comprises preoperative PSA level, specimen Gleason sum, prostatic capsular invasion level, surgical margin status, presence of seminal vesicle invasion, and lymph node status; and
a means for comparing an identical set of factors determined from the patient diagnosed as having prostatic cancer to the correlation to predict the quantitative probability of recurrence of prostatic cancer in the patient following radical prostatectomy.
- a correlation of clinical and pathological factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by radical prostatectomy with incidence of recurrence of prostatic cancer for each person of said plurality of persons wherein said selected set of factors comprises preoperative PSA level, specimen Gleason sum, prostatic capsular invasion level, surgical margin status, presence of seminal vesicle invasion, and lymph node status; and
- 28. A nomogram for the graphic representation of a quantitative probability that a patient with prostate cancer will remain free of disease following radical prostatectomy comprising a plurality of scales and a solid support, the plurality of scales being disposed on said support and comprising a preoperative PSA level scale, a specimen Gleason sum scale, a prostatic capsular invasion level scale, a surgical margin status scale, a presence of seminal vesicle invasion scale, a lymph node status scale, a points scale, a total points scale and a predictor scale, wherein said preoperative PSA level scale, specimen Gleason sum scale, prostatic capsular invasion level scale, surgical margin status scale, presence of seminal vesicle invasion scale, and lymph node status scale each have values on said scales, and wherein said preoperative PSA level scale, said specimen Gleason sum scale, said prostatic capsular invasion level scale, said surgical margin status scale, said presence of seminal vesicle invasion scale, and said lymph node status scale are disposed on said solid support with respect to the points scale so that each of said values on said preoperative PSA level scale, said specimen Gleason sum scale, said prostatic capsular invasion level scale, said surgical margin status scale, said presence of seminal vesicle invasion scale, and said lymph node status scale can be correlated with values on the points scale, and wherein said total points scale has values on said total points scale and wherein said total points scale is disposed on said solid support with respect to the predictor scale so that said values on said total points scale may be correlated with values on the predictor scale, such that the values on the points scale correlating with the patient'"'"'s preoperative PSA level, specimen Gleason sum, prostatic capsular invasion level, surgical margin status, presence of seminal vesicle invasion, and lymph node status can be added together to yield a total points value, and the total points value can be correlated with the predictor scale to predict the quantitative probability of recurrence.
Specification