D'Amico A V
Joint Center for Radiation Therapy, Harvard Medical School, Boston, Massachusetts, USA.
Magn Reson Imaging Clin N Am. 1996 Aug;4(3):471-9.
Combined modality staging is a methodology in which all of the pretreatment clinical factors that are found to have independent prognostic significance on multivariable analysis for predicting a given outcome (e.g., pathologic stage) are used to determine the initial management. This method of staging provides an optimized assessment of the pathologic extent of local disease prior to management, and therefore is better able to define those patients in whom local only therapy is likely to be curative. Knowing more about the pathologic extent of disease prior to therapy provides a rationale for patient selection in clinical trials that test new management strategies against the current standards. The preoperative endorectal coil MR imaging study results have been shown on multivariable analysis (which included PSA, clinical stage, and biopsy Gleason score) to provide statistically independent prognostic information about the outcomes of pathologic stage, margin status, postoperative PSA failure, and the prediction of local only failure in the positive margin patient.
