1122 DEVELOPMENT OF A NOVEL PREOPERATIVE NOMOGRAM INCLUDING THE BIOMARKER MICRO-RNA 221 - PREDICTING CANCER SPECIFIC MORTALITY IN HIGH RISK PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 20121122 DEVELOPMENT OF A NOVEL PREOPERATIVE NOMOGRAM INCLUDING THE BIOMARKER MICRO-RNA 221 - PREDICTING CANCER SPECIFIC MORTALITY IN HIGH RISK PROSTATE CANCER Martin Spahn, Firas Abdolah, Steven Joniau, Philip Ströbel, Paolo Gontero, Maria Schubert, Burkhard Kneitz, and Alberto Briganti Martin SpahnMartin Spahn Würzburg, Germany More articles by this author , Firas AbdolahFiras Abdolah Milan, Italy More articles by this author , Steven JoniauSteven Joniau Leuven, Belgium More articles by this author , Philip StröbelPhilip Ströbel Mannheim, Germany More articles by this author , Paolo GonteroPaolo Gontero Turin, Italy More articles by this author , Maria SchubertMaria Schubert Würzburg, Germany More articles by this author , Burkhard KneitzBurkhard Kneitz Würzburg, Germany More articles by this author , and Alberto BrigantiAlberto Briganti Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1231AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Several studies have shown that the outcome of high-risk prostate cancer (PCa) is not invariably poor. However, not many tools predicting cancer specific survival (CSS) are available for this patient category. We recently described the micro-RNA-221 as a new marker to predict cancer specific survival in high-risk PCa. The aim of this study was to develop a new biomarker based preoperative nomogram to predict CSS in high risk PCa patients as a proof of principle. METHODS The study included 128 patients with pre-operative high risk PCa (PSA≥20 ng/ml, cT3, biopsy Gleason 8-10) treated with RP + pelvic lymph node dissection between 1989 and 2006. All patients had pre-operative data (including PSA at surgery, biopsy Gleason sum, clinical stage) as well as post-operative pathological information (including pathological stage and Gleason sum, surgical and lymph node status, number of lymph nodes removed). Moreover, data regarding use of adjuvant treatments were available for all patients. Single pathology review was performed by one senior uro-pathologists (P.S.). Only tumor areas with >90% PCa were isolated and used for the molecular workup. Univariable and multivariable logistic regression models tested the association between predictors (PSA, age, clinical stage, biopsy Gleason sum and miR-221) and CSS. A logistic regression coefficient-based nomogram was developed with and without miR-221. The AUC quantified the predictive accuracy of the model. The Kaplan Meier method was used to depict cancer specific survival (CSS) rates according to tumor characteristics. RESULTS Median follow-up was 82 moths (1-154). 10- and 15-years CSS rated were 88% and 72%, respectively. miR-221 was progressively down-regulated in aggressive forms of prostate carcinoma. At univariable and multivariable analyses, miR-221 was an independent predictor for CSS (all p≤0.003). A nomogram including PSA, age, clinical stage and biopsy Gleason sum demonstrated 79.8% accuracy. The nomogram adding of miR-221 into this nomogram increased the accuracy to 86.6%. CONCLUSIONS Long term outcome of high-risk patients is not invariably poor. We developed the first nomogram predicting CSS in clinically high risk PCa patients based on routinely available pre-operative parameters and the new biomarker miR-221. This proof of principle nomogram might significantly contribute to the selection of patients at highest risk for prostate cancer related death who need additional aggressive multimodal treatment. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e455 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Martin Spahn Würzburg, Germany More articles by this author Firas Abdolah Milan, Italy More articles by this author Steven Joniau Leuven, Belgium More articles by this author Philip Ströbel Mannheim, Germany More articles by this author Paolo Gontero Turin, Italy More articles by this author Maria Schubert Würzburg, Germany More articles by this author Burkhard Kneitz Würzburg, Germany More articles by this author Alberto Briganti Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...