MP60-13 WHEN TO ORDER GENOMIC TESTS: DEVELOPMENT AND EXTERNAL VALIDATION OF A MODEL TO PREDICT HIGH RISK PROSTATE CANCER AT THE GENOTYPIC LEVEL

Abstract

You have accessJournal of UrologyProstate Cancer: Markers (MP60)1 Sep 2021MP60-13 WHEN TO ORDER GENOMIC TESTS: DEVELOPMENT AND EXTERNAL VALIDATION OF A MODEL TO PREDICT HIGH RISK PROSTATE CANCER AT THE GENOTYPIC LEVEL Ugo Falagario, Alberto Martini, Mohammed Shahait, Ayah El-Fahmawi, Ivan Jambor, Anna Lantz, David Grannas, Vinayak Wagaskar, Parita Ratnani, Dara Ludon, Kenneth Haines, Luigi Cormio, Giuseppe Carrieri, Natasha Kyprianou, Michael Kattan, Eric Klein, Peter Wiklund, David Lee, and Ashutosh Tewari Ugo FalagarioUgo Falagario More articles by this author , Alberto MartiniAlberto Martini More articles by this author , Mohammed ShahaitMohammed Shahait More articles by this author , Ayah El-FahmawiAyah El-Fahmawi More articles by this author , Ivan JamborIvan Jambor More articles by this author , Anna LantzAnna Lantz More articles by this author , David GrannasDavid Grannas More articles by this author , Vinayak WagaskarVinayak Wagaskar More articles by this author , Parita RatnaniParita Ratnani More articles by this author , Dara LudonDara Ludon More articles by this author , Kenneth HainesKenneth Haines More articles by this author , Luigi CormioLuigi Cormio More articles by this author , Giuseppe CarrieriGiuseppe Carrieri More articles by this author , Natasha KyprianouNatasha Kyprianou More articles by this author , Michael KattanMichael Kattan More articles by this author , Eric KleinEric Klein More articles by this author , Peter WiklundPeter Wiklund More articles by this author , David LeeDavid Lee More articles by this author , and Ashutosh TewariAshutosh Tewari More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002095.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiple studies have been focusing on the role of MRI and clinical variables in predicting high risk prostate cancer (PCa) at the time of radical prostatectomy (RP). Although PCa grading and staging represent strong predictors of PCa oncologic outcomes, they only take into account the phenotypic features of the tumor. To the best of our knowledge, no studies have been focusing on the prediction of high risk PCa at a genotypic level.The aim of this study was to develop and externally validate a model to predict high risk PCa according to the Decipher score, a validated 22 gene prognostic panel. METHODS: We retrospectively reviewed IRB approved databases at two institutions to develop and externally validate a multivariable model. Patients who underwent RP with Decipher test and preoperative MRI were included in the analysis. Primary outcome was high risk Decipher on RP specimen. Uni- and multivariable analyses were performed to create a model predicting High Risk Decipher score. Area under the curve (AUC) and calibration were used to assess the accuracy of the model before and after leave one out cross validation (LOOCV) in the development and validation cohort. Finally, Decision curve analysis (DCA) was performed to assess the clinical benefit of the model. RESULTS: The development and validation cohort included 622 and 185 patients from two different institutions with 283 (35%) and 80 (43%) of those with High risk Decipher score. The multivariate model with the best performance included PSA density, biopsy Gleason Grade Group, percentage of positive cores and MRI ECE. AUC was 0.73 after LOOCV and the calibration was excellent. DCA showed a clinical benefit in a range of probabilities between 15 and 60%. In the external validation cohort, AUC was 0.70 but the model slightly underestimated the actual probability of the outcome. CONCLUSIONS: We developed and externally validated a model to predict High risk Decipher score at radical prostatectomy. This model could be helpful to improve risk stratification of patients with PCa and to assess the need for additional testing and treatments. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1046-e1047 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ugo Falagario More articles by this author Alberto Martini More articles by this author Mohammed Shahait More articles by this author Ayah El-Fahmawi More articles by this author Ivan Jambor More articles by this author Anna Lantz More articles by this author David Grannas More articles by this author Vinayak Wagaskar More articles by this author Parita Ratnani More articles by this author Dara Ludon More articles by this author Kenneth Haines More articles by this author Luigi Cormio More articles by this author Giuseppe Carrieri More articles by this author Natasha Kyprianou More articles by this author Michael Kattan More articles by this author Eric Klein More articles by this author Peter Wiklund More articles by this author David Lee More articles by this author Ashutosh Tewari More articles by this author Expand All Advertisement Loading ...