PD28-03 CORRELATION BETWEEN A GENOMICS TEST AND ADVERSE PATHOLOGY AFTER RADICAL PROSTATECTOMY AMONG ACTIVE SURVEILLANCE CANDIDATES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I1 Apr 2017PD28-03 CORRELATION BETWEEN A GENOMICS TEST AND ADVERSE PATHOLOGY AFTER RADICAL PROSTATECTOMY AMONG ACTIVE SURVEILLANCE CANDIDATES Patrick Hurley, Greg Auffenberg, Ji Qi, Chris Maurino, Samantha Farida, Ivi Latifi, Donald Moylan, Bincy Johnson, David Miller, Kirk Wojno, and Michigan Urological Surgery Improvement Collaborative Patrick HurleyPatrick Hurley More articles by this author , Greg AuffenbergGreg Auffenberg More articles by this author , Ji QiJi Qi More articles by this author , Chris MaurinoChris Maurino More articles by this author , Samantha FaridaSamantha Farida More articles by this author , Ivi LatifiIvi Latifi More articles by this author , Donald MoylanDonald Moylan More articles by this author , Bincy JohnsonBincy Johnson More articles by this author , David MillerDavid Miller More articles by this author , Kirk WojnoKirk Wojno More articles by this author , and Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1237AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is growing interest among urologists in the community about the extent to which prostate cancer (CaP) genomic tests can further risk stratify men who are candidates for active surveillance (AS). In this context, we evaluated the relationship between results from the Prolaris cell cycle progression genomics test and the frequency of adverse pathological outcomes among men treated with radical prostatectomy (RP) in a large, community-based practice. METHODS For all patients undergoing Prolaris testing in a large urology practice from 7/2013 through 4/2016, we linked test results with clinical data from the Michigan Urological Surgery Improvement Collaborative (MUSIC) clinical registry. We then identified all men that met the published MUSIC appropriateness criteria for AS (i.e., any Gleason Score (GS) =6 or GS 3+4 with =3 positive cores and no more than 50% of any core involved), and also underwent RP as primary therapy. Genomic test results with an estimated 10-year CaP-specific mortality >3% were classified as high-risk. We then compared the frequency of adverse pathological outcomes with RP – defined as the presence of primary Gleason pattern 4 or 5 cancer and/or pathological stage T3 or T4 disease – among men with high- versus low-risk genomics results. RESULTS We identified 118 patients who were candidates for AS based on MUSIC criteria, had a Prolaris test, and primary treatment with RP. Among the entire group, 49 (42%) and 69 patients (58%) had low and high-risk genomics results, respectively. When limited to patients with only GS 6 cancer on diagnostic biopsy (n=26), only 4 men (15%) had high-risk Prolaris results. For the entire cohort (Figure 1a), patients with high-risk genomic results were more likely to have pathological stage T3 or T4 tumors (36.2% vs 12.2%, p =0.004). Among the men with only GS 6 cancer on biopsy, none of the 22 patients with a low-risk genomics result had primary pattern 4 or 5 cancer (Figure 1b). CONCLUSIONS Among patients seen in a large, community practice who are candidates for AS, high-risk results from a cell cycle progression genomics test are more frequently associated with the presence of T3 or T4 disease at RP. Our findings suggest a potentially useful role for these tests in further risk-stratifying men considering AS for early-stage CaP. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e517-e518 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Patrick Hurley More articles by this author Greg Auffenberg More articles by this author Ji Qi More articles by this author Chris Maurino More articles by this author Samantha Farida More articles by this author Ivi Latifi More articles by this author Donald Moylan More articles by this author Bincy Johnson More articles by this author David Miller More articles by this author Kirk Wojno More articles by this author Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...