{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:21:11Z","timestamp":1765887671527,"version":"build-2065373602"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,12,9]],"date-time":"2014-12-09T00:00:00Z","timestamp":1418083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA100938"],"award-info":[{"award-number":["R01CA100938"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P50 CA92131-01A1"],"award-info":[{"award-number":["P50 CA92131-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24CA160653"],"award-info":[{"award-number":["K24CA160653"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001129","name":"Georgia Cancer Coalition","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Clinical stage T2c (cT2c) is an indeterminate factor in prostate cancer (PC) risk stratification. According to the D'Amico grouping and American Urological Association guidelines, cT2c is a high risk, whereas the National Comprehensive Cancer Network and the European Urological Association classify cT2c as an intermediate risk. This study assessed whether cT2c tumors without other high\u2010risk factors (clinical stage T2c, not otherwise specified [cT2c\u2010NOS]) behaved as an intermediate or high risk through an analysis of biochemical recurrence (BCR) after radical prostatectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Two thousand seven hundred fifty\u2010nine men from the Shared Equal Access Regional Cancer Hospital (SEARCH) Database and 12,900 men from Johns Hopkins Hospital (JHH) from 1988\u20102011 and 1982\u20102012, respectively, were analyzed. Patients were grouped into low\u2010risk (prostate\u2010specific antigen [PSA] &lt; 10 ng\/mL, Gleason sum \u2264 6, and cT1\u2010T2a), intermediate\u2010risk (PSA = 10\u201020 ng\/mL, Gleason sum = 7, or cT2b), and high\u2010risk PC categories (PSA &gt; 20 ng\/mL, Gleason sum = 8\u201010, or cT3). Men with cT2c tumors who were not otherwise at high risk (ie, PSA&lt; 20 ng\/mL and Gleason sum &lt; 8) were placed into a separate category termed cT2c\u2010NOS. Associations between cT2c\u2010NOS and intermediate\u2010 and high\u2010risk patients and BCR were tested with the log\u2010rank test and Cox proportional analysis models.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Ninety\u2010nine men (4%) from SEARCH and 202 men (2%) from JHH had tumors classified as cT2c\u2010NOS. The cT2c\u2010NOS patients had a BCR risk similar to that of the intermediate\u2010risk patients (SEARCH, <jats:italic>P<\/jats:italic> = .27; JHH, <jats:italic>P<\/jats:italic> = .23) but a significantly lower BCR risk in comparison with the high\u2010risk patients (SEARCH, <jats:italic>P<\/jats:italic> &lt; .001; JHH, <jats:italic>P<\/jats:italic> &lt; .001). When they were specifically compared with intermediate\u2010 and high\u2010risk patients, after adjustments for year and center, cT2c\u2010NOS patients had outcomes comparable to those of intermediate\u2010risk patients (SEARCH, <jats:italic>P<\/jats:italic> = .53; JHH, <jats:italic>P<\/jats:italic> = .54) but significantly better than those of high\u2010risk patients (SEARCH, <jats:italic>P<\/jats:italic> = .003; JHH, <jats:italic>P<\/jats:italic> &lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Patients with cT2c disease without other high\u2010risk features had outcomes similar to the outcomes of patients with intermediate\u2010risk PC and significantly better than the outcomes of patients with high\u2010risk PC. These findings suggest that men with cT2c disease should be considered to be at intermediate risk. <jats:bold><jats:italic>Cancer<\/jats:italic> 2015;121:1414\u20131421.<\/jats:bold> \u00a9 <jats:italic>2014 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.29147","type":"journal-article","created":{"date-parts":[[2014,12,9]],"date-time":"2014-12-09T14:36:44Z","timestamp":1418135804000},"page":"1414-1421","source":"Crossref","is-referenced-by-count":14,"title":["Is clinical stage T2c prostate cancer an intermediate\u2010 or high\u2010risk disease?"],"prefix":"10.1002","volume":"121","author":[{"given":"Zachary","family":"Klaassen","sequence":"first","affiliation":[{"name":"Medical College of Georgia Georgia Regents University Augusta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhay A.","family":"Singh","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren E.","family":"Howard","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham North Carolina"},{"name":"Durham Veterans Affairs Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaoyong","family":"Feng","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Trock","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha K.","family":"Terris","sequence":"additional","affiliation":[{"name":"Medical College of Georgia Georgia Regents University Augusta Georgia"},{"name":"Augusta Veterans Affairs Medical Center Augusta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William J.","family":"Aronson","sequence":"additional","affiliation":[{"name":"West Los Angeles Veterans Affairs Medical Center West Los Angeles California"},{"name":"University of California Los Angeles School of Medicine Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Cooperberg","sequence":"additional","affiliation":[{"name":"University of California San Francisco San Francisco California"},{"name":"San Francisco Veterans Affairs Medical Center San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher L.","family":"Amling","sequence":"additional","affiliation":[{"name":"Oregon Health &amp; Sciences University Portland Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Kane","sequence":"additional","affiliation":[{"name":"University of California San Diego San Diego California"},{"name":"San Diego Veterans Affairs Medical Center San Diego California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Partin","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misop","family":"Han","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen J.","family":"Freedland","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham North Carolina"},{"name":"Durham Veterans Affairs Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.02.054"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.11.969"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2014.0072"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.03.003"},{"key":"e_1_2_7_6_1","unstructured":"HeidenreichA BastianPJ BellmuntJ et al.Guidelines on prostate cancer.http:\/\/www.uroweb.org\/gls\/pdf\/09_Prostate_Cancer_LR.pdf. 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