CLINICAL STAGE, PROSTATE-SPECIFIC ANTIGEN AND GLEASON GRADE TO PREDICT EXTRACAPSULAR DISEASE OR NODAL METASTASIS IN MEN WITH NEWLY-DIAGNOSED, PREVIOUSLY UNTREATED PROSTATE-CANCER - A MULTICENTER STUDY

Objective: To draw nomograms for preoperative predictions of extracaps ular and of nodal disease based upon preoperative prostate-specific an tigen, Gleason grade and clinical stage. Methods: The complete charts of 1,738 patients submitted to radical retropubic prostatectomy in 34 Italian urological departments have been reviewed. The correlation bet ween preoperative variables and pathological examination was tested by both univariate and multivariate techniques. Logistic regression anal ysis with the likelihood ratio chi(2) test was used to predict the pat hological features (T > = 3; N+) of a patient for various combinations of preoperative variables. Results: Probability plots were constructe d for the prediction of either extracapsular disease or lymph node inv olvement by the above-mentioned combination of preoperative variables. Conclusions: The obtained probability curves could be useful for pati ent counselling, for planning a staging laparoscopic lymphadenectomy i n high-risk patients and for deciding whether to perform a nerve-spari ng prostatectomy.