A proposed American Joint Committee on Cancer-compliant clinical prognostic stage group system for prostate cancer may be used to inform therapeutic decision-making and future clinical trial design, according to a recent study in JAMA Oncology (2020. doi:10.1001/jamaoncol.2020.4922).
“In 2016, the American Joint Committee on Cancer (AJCC) established criteria to evaluate prediction models for staging,” wrote the study authors. “No localized prostate cancer models were endorsed by the Precision Medicine Core committee, and 8th edition staging was based on expert consensus.”
The multinational cohort study used data from 55 centers from the United States, Canada, and Europe and aimed to develop and validate a pretreatment clinical prognostic stage group system for nonmetastatic prostate cancer.
The study included data from 19,684 men with nonmetastatic prostate cancer and a median age of 64 years. Of these, 12,421 were treated with radical prostatectomy and 7263 with radiotherapy.
The Score system performance was similar to individualized random survival forest, but it outperformed the National Comprehensive Cancer Network and Cancer of the Prostate Risk Assessment risk grouping 3- and 4-tier classification systems, as well as the existing AJCC system.
“Using a large, diverse international cohort treated with standard curative treatment options, a proposed AJCC-compliant clinical prognostic stage group system for prostate cancer has been developed,” concluded Robert Dess, MD, Department of Radiation Oncology, University of Michigan School of Medicine (Ann Arbor, MI). “This system may allow consistency of reporting and interpretation of results and clinical trial design.”—Lisa Kuhns
