Nomograms to aid in the treatment of prostatic cancer

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 specimen Gleason sum 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 specimen Gleason sum 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 specimen Gleason sum 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 specimen Gleason sum 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 specimen Gleason sum, 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.

A method for predicting a quantitative probability of recurrence of prostatic cancer in a patient following treatment with an identified therapy comprising the steps of:

• correlating a selected set of factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by said identified therapy 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 factors comprises at least two factors selected from the group consisting of pretreatment PSA level, combined Gleason grade, specimen Gleason sum, clinical stage, surgical margin status, prostatic capsular invasion level, extraprostatic extension, level of extraprostatic extension, apoptotic index, maximum cancer length in a core, total length of cancer in the biopsy cores, percent of cores positive, percent of cancer in one or more cores, percent of high grade cancer in one or more cores, total tumor volume, zone of location of the cancer, presence of seminal vesicle invasion, type of seminal vesicle invasion, p53, Ki-67, p27, DNA ploidy status, lymph node status, and lymphovascular invasion, wherein said functional representation of the correlation comprises a different factor evaluation system for each of said factors, and wherein each of said factor evaluation systems provides a value corresponding with a status of said corresponding factor, which value may be summed with values corresponding to the status of the other factors in the selected set to derive a quantitative probability of recurrence of prostatic cancer following said identified therapy;
• determining the status of an identical set of factors for the patient;
• applying the status of each of the patient's set of factors to said corresponding factor evaluation system to determine a patient value for each of said factors;
• and
• summing the patient's values to derive the quantitative probability of recurrence of prostatic cancer in the patient following said identified therapy.

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, clinical stage, and one or more supplemental factors selected from the group consisting of apoptotic index, maximum cancer length in a core, percent of cores positive, percent of cancer in one or more cores, percent of high grade cancer in one or more cores and total length of cancer in the biopsy cores, wherein said functional representation of the correlation comprises a pretreatment PSA level scale, a clinical stage scale, a combined Gleason grade scale, one or more supplemental factor scales for each of said one or more supplemental factors, a points scale, a total points scale, and a predictor scale, and wherein said pretreatment PSA level scale, said clinical stage scale, said combined Gleason grade scale and said one or more supplemental factors scales 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;
• matching the patient's one or more supplemental factors to one or more corresponding values on the one or more supplemental factor scales to determine one or more supplemental point values on the points scale;
• adding the first, second and third and one or more supplemental 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.

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:

• 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 specimen Gleason sum, 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 specimen Gleason sum 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 specimen Gleason sum 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 specimen Gleason sum to a corresponding value on the specimen Gleason sum scale, and determining a first 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 second 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 third 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 fourth point value from the corresponding value on the points scale;
• adding the first, second, third, and fourth 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.

A method of using a computer processor for predicting a quantitative probability of recurrence of prostatic cancer in a patient following treatment with an identified therapy comprising the steps of:

• correlating a selected set of factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by said identified therapy with incidence of recurrence of prostatic cancer for each person of said plurality of persons to generate a functional representation of the correlation using said computer processor, wherein said selected set of factors comprises at least two factors selected from the group consisting of pretreatment PSA level, combined Gleason grade, specimen Gleason sum, clinical stage, surgical margin status, prostatic capsular invasion level, extraprostatic extension, level of extraprostatic extension, apoptotic index, maximum cancer length in a core, total length of cancer in the biopsy cores, percent of cores positive, percent of cancer in one or more cores, percent of high grade cancer in one or more cores, total tumor volume, zone of location of the cancer, presence of seminal vesicle invasion, type of seminal vesicle invasion, p53, Ki-67, p27, DNA ploidy status, lymph node status, and lymphovascular invasion, wherein said functional representation of the correlation comprises a different factor evaluation system for each of said factors, and wherein each of said factor evaluation systems provides a value corresponding with a status of said corresponding factor, which value may be summed with values corresponding to the status of the other factors in the selected set to derive a quantitative probability of recurrence of prostatic cancer following said identified therapy;
• determining the status of an identical set of factors for the patient using said computer processor;
• applying the status of each of the patient's set of factors to said corresponding factor evaluation system to determine a patient value for each of said factors using said computer processor;
• and
• summing the patient's values to derive the quantitative probability of recurrence of prostatic cancer in the patient following said identified therapy.

A computerized method for predicting a quantitative probability of recurrence of prostatic cancer in a patient following treatment with an identified therapy comprising the steps of:

• correlating a selected set of factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by said identified therapy 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 factors comprises at least two factors selected from the group consisting of pretreatment PSA level, combined Gleason grade, specimen Gleason sum, clinical stage, surgical margin status, prostatic capsular invasion level, extraprostatic extension, level of extraprostatic extension, apoptotic index, maximum cancer length in a core, total length of cancer in the biopsy cores, percent of cores positive, percent of cancer in one or more cores, percent of high grade cancer in one or more cores, total tumor volume, zone of location of the cancer, presence of seminal vesicle invasion, type of seminal vesicle invasion, p53, Ki-67, p27, DNA ploidy status, lymph node status, and lymphovascular invasion, wherein said functional representation of the correlation comprises a different factor evaluation system for each of said factors, and wherein each of said factor evaluation systems provides a value corresponding with a status of said corresponding factor, which value may be summed with values corresponding to the status of the other factors in the selected set to derive a quantitative probability of recurrence of prostatic cancer following said identified therapy;
• determining the status of an identical set of factors for the patient;
• applying the status of each of the patient's set of factors to said corresponding factor evaluation system to determine a patient value for each of said factors;
• and
• summing the patient's values to derive the quantitative probability of recurrence of prostatic cancer in the patient following said identified therapy.

An apparatus for predicting a quantitative probability of disease recurrence in a patient with prostatic cancer following an identified therapy, wherein the apparatus comprises:

• a correlation of factors determined for each of a plurality of persons previously diagnosed with prostatic cancer and having been treated by said identified therapy with incidence of recurrence of prostatic cancer for each person of said plurality of persons, wherein said selected set of factors comprises two or more factors selected from the group consisting of pretreatment PSA level, combined Gleason grade, specimen Gleason sum, clinical stage, surgical margin status, prostatic capsular invasion maximum cancer length in a core, total length of cancer in the biopsy cores, percent of cores positive level, extraprostatic extension, level of extraprostatic extension, apoptotic index, percent of cancer in one or more cores, percent of high grade cancer in one or more cores, total tumor volume, zone of location of the cancer, presence of seminal vesicle invasion, type of seminal vesicle invasion, p53, Ki-67, p27, DNA ploidy status, lymph node status, and lymphovascular invasion;
• 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 said identified therapy.