Prognostic factors in prostate cancer

Prognostic factors in prostate cancer must be significant, independent and clinically important. "Significant" means the factor rarely occurs by chance, "independent" means the factor retains its value even when new factors are added and "clinically important" means the factor influences therapy. They should furthermore be classified into patient-related, tumor-related and treatment-related factors. If new prognostic factors are established without adherence to these guidelines, there results an exponential increase of meaningless parameters, as an individual patient can only belong to one prognostic group. Prognostic factors with established values are metastases, lymph node involvement, grade, positive margins, extracapsular extension and seminal vesical invasion. Among the classic and new biomarkers, only PSA has been of value for prediction of progression-free survival.