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<p>[QUOTE="Anonymous, post: 2860818"]EDITORIAL </p><p><br /></p><p>Systems Pathology and Predicting Outcome After Radical Prostatectomy</p><p>Eric A. Klein, Andrew J. Stephenson, Derek Raghavan, Robert Dreicer </p><p>Glickman Urologic and Kidney Institute and Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH </p><p><br /></p><p>...</p><p><br /></p><p><b>Excitement over this potential improvement in accuracy must be tempered by limitations in its clinical utility. In an additional analysis, the authors compared the concordance index for the systems pathology–derived model with that of a 10-variable model that contained only the usual clinical parameters (stage, PSA, biopsy Gleason score and sum, prostatectomy Gleason score and sum, and pathologic extent in the prostatectomy specimen) generated by Cox regression. In this analysis, the concordance index for the 10-variable clinical model was 0.80 and improved only slightly to 0.83 for the systems pathology approach. The corresponding hazard ratios for clinical failure were 6.37 and 9.11, respectively. Although the difference in concordance indices was statistically significant, the question is whether there is sufficient clinical relevance to justify the extra effort, expense, and expertise needed for the systems approach.</b>[/U] <b><u>The clinical utility of defining high risk for failure after radical prostatectomy is to decide whether patients require closer follow-up than average or whether adjuvant radiotherapy, hormone therapy, or chemotherapy would be of benefit. In contemporary practice, a patient with a hazard ratio of 6.37 generated by the model using easily derived, routinely reported clinical and pathologic parameters is just as likely to be a candidate for closer monitoring or adjuvant therapy than one with a hazard ratio of 9.11 generated by the systems approach.</u></b><u> </u></p><p><u></u>[/QUOTE]<u></u></p><p><u><br /></u></p><p><u>Great post: Also keep in mind that this publication was based on prostate sections and not biopsies - the accuracy of the biopsy based test is even lower than for sections, meaning that the clinical benefit vs. cost is even lower.</u>[/QUOTE]</p><p><br /></p>
[QUOTE="Anonymous, post: 2860818"]EDITORIAL Systems Pathology and Predicting Outcome After Radical Prostatectomy Eric A. Klein, Andrew J. Stephenson, Derek Raghavan, Robert Dreicer Glickman Urologic and Kidney Institute and Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH ... [B]Excitement over this potential improvement in accuracy must be tempered by limitations in its clinical utility. In an additional analysis, the authors compared the concordance index for the systems pathology–derived model with that of a 10-variable model that contained only the usual clinical parameters (stage, PSA, biopsy Gleason score and sum, prostatectomy Gleason score and sum, and pathologic extent in the prostatectomy specimen) generated by Cox regression. In this analysis, the concordance index for the 10-variable clinical model was 0.80 and improved only slightly to 0.83 for the systems pathology approach. The corresponding hazard ratios for clinical failure were 6.37 and 9.11, respectively. Although the difference in concordance indices was statistically significant, the question is whether there is sufficient clinical relevance to justify the extra effort, expense, and expertise needed for the systems approach.[/B][/U] [B][U]The clinical utility of defining high risk for failure after radical prostatectomy is to decide whether patients require closer follow-up than average or whether adjuvant radiotherapy, hormone therapy, or chemotherapy would be of benefit. In contemporary practice, a patient with a hazard ratio of 6.37 generated by the model using easily derived, routinely reported clinical and pathologic parameters is just as likely to be a candidate for closer monitoring or adjuvant therapy than one with a hazard ratio of 9.11 generated by the systems approach.[/U][/B][U] [/QUOTE] Great post: Also keep in mind that this publication was based on prostate sections and not biopsies - the accuracy of the biopsy based test is even lower than for sections, meaning that the clinical benefit vs. cost is even lower.[/u][/QUOTE]
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Cafepharma Message Boards | Pharma Sales, Device Sales, Lab Sales
Home
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Cafepharma Message Boards | Pharma Sales, Device Sales, Lab Sales
Home
Forums
>
Therapeutic Specialties
>
Urology
>
Aureon Labs
>