MP28-13 PROGNOSTIC UTILITY OF BIOPSY-DERIVED CELL CYCLE PROGRESSION SCORE IN PATIENTS WITH NCCN LOW-RISK PROSTATE CANCER UNDERGOING RADICAL PROSTATECTOMY: IMPLICATIONS FOR TREATMENT GUIDANCE

Abstract

You have accessJournal of UrologyProstate Cancer: Markers I1 Apr 2017MP28-13 PROGNOSTIC UTILITY OF BIOPSY-DERIVED CELL CYCLE PROGRESSION SCORE IN PATIENTS WITH NCCN LOW-RISK PROSTATE CANCER UNDERGOING RADICAL PROSTATECTOMY: IMPLICATIONS FOR TREATMENT GUIDANCE Jeffrey Tosoian, Meera Chappidi, Jay Bishoff, Stephen Freedland, Julia Reid, Michael Brawer, Steven Stone, Thorsten Schlomm, and Ashley Ross Jeffrey TosoianJeffrey Tosoian More articles by this author , Meera ChappidiMeera Chappidi More articles by this author , Jay BishoffJay Bishoff More articles by this author , Stephen FreedlandStephen Freedland More articles by this author , Julia ReidJulia Reid More articles by this author , Michael BrawerMichael Brawer More articles by this author , Steven StoneSteven Stone More articles by this author , Thorsten SchlommThorsten Schlomm More articles by this author , and Ashley RossAshley Ross More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.826AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies have demonstrated that the cell cycle progression (CCP) score measured in prostate biopsy specimens was predictive of several clinical outcomes. However, it is currently unclear whether the CCP score improves clinical risk stratification within Gleason score (GS) 6 cancers and the subset of patients with National Comprehensive Cancer Network (NCCN) low-risk disease. Therefore, our objective was to determine the prognostic utility of the CCP score in men with NCCN low-risk disease who underwent radical prostatectomy (RP). METHODS Patients who underwent RP for GS ≤6 prostate cancer at three institutions (Martini Clinic [MC], Durham Veterans Affairs Medical Center [DVA], and Intermountain Healthcare [IHC]) were identified. The CCP score was obtained from diagnostic (DVA, IHC) or simulated biopsies (MC). Primary outcome was biochemical recurrence (BCR, PSA≥0.2 ng/ml) after RP. Prognostic utility of the CCP score was assessed using Kaplan-Meier analysis and multivariable Cox proportional hazards models in the subset of men meeting NCCN low-risk criteria and the overall cohort (all GS ≤6 prostate cancer patients). RESULTS Among the 236 patients identified, 80% (188/236) met NCCN low-risk criteria. Five-year BCR-free survival for the low (<0), intermediate (0-1), and high (>1) CCP score groups was 89.2%, 80.4%, 64.7%, respectively in the low-risk cohort (log-rank p=0.027), and 85.9%, 79.1%, 63.1% respectively in the overall cohort (log-rank p=0.041). In multivariable models adjusting for clinical and pathological variables with the CAPRA score, the CCP score was an independent predictor of BCR in the low-risk (HR=1.77 per unit score, 95%CI [1.21, 2.58], p=0.003) and overall cohorts (HR=1.41 per unit score, 95%CI [1.02, 1.96], p=0.039). CONCLUSIONS In a cohort of NCCN low-risk patients, the CCP score improved clinical risk stratification of patients at increased risk of BCR. This suggests the CCP score could help improve the assessment of candidacy for active surveillance and guide optimal treatment selection in patients with NCCN low-risk prostate cancer. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e343 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jeffrey Tosoian More articles by this author Meera Chappidi More articles by this author Jay Bishoff More articles by this author Stephen Freedland More articles by this author Julia Reid More articles by this author Michael Brawer More articles by this author Steven Stone More articles by this author Thorsten Schlomm More articles by this author Ashley Ross More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...