PD42-10 PROGNOSTIC VALUE OF CELL CYCLE PROGRESSION SCORE IN PROSTATE CANCER PATIENTS WITH LOCALLY ADVERSE PATHOLOGY AFTER RADICAL PROSTATECTOMY: IMPLICATIONS FOR TREATMENT GUIDANCE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VI1 Apr 2018PD42-10 PROGNOSTIC VALUE OF CELL CYCLE PROGRESSION SCORE IN PROSTATE CANCER PATIENTS WITH LOCALLY ADVERSE PATHOLOGY AFTER RADICAL PROSTATECTOMY: IMPLICATIONS FOR TREATMENT GUIDANCE Xun Shangguan, Wei Xue, Baijun Dong, Jiahua Pan, Hongyang Qian, and Fan Xu Xun ShangguanXun Shangguan More articles by this author , Wei XueWei Xue More articles by this author , Baijun DongBaijun Dong More articles by this author , Jiahua PanJiahua Pan More articles by this author , Hongyang QianHongyang Qian More articles by this author , and Fan XuFan Xu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1963AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer (PCa) patients with locally adverse pathologic features (including extracapsular extension (ECE), seminal vesicle invasion (SVI), or positive surgical margins (PSM)) are considered as poor prognostic factors. Evidences form randomized trials (SWOG-8794, EORTC 22911, and ARO 96-02) suggests that adjuvant radiotherapy is appropriate for patients with high-risk features because it can significantly improve disease-free survival. However, the outcomes of surgically treated patients with locally adverse pathologic features are not invariably poor, with not every patient will suffer eventual cancer recurrence and the policy of adjuvant radiotherapy could lead to the potential for overtreatment. Therefore, correct identification of patients who most likely to benefit from adjuvant therapy is of paramount importance. Tissue-based genomic tests, such as the cell cycle progression (CCP) score, can help decrease prognostic uncertainty and improve risk stratification of PCa. The aim of this study was to determine the prognostic utility of the CCP score in men with locally adverse pathology undergoing radical prostatectomy. METHODS Data on 100patients with locally adverse pathologic features (including ECE, SVI, or PSM) who had been treated with wait and see policy after RP were retrospectively analyzed for biochemical recurrence (BCR)-free survival. CCP score were retrospectively derived from prostatectomy specimens. Kaplan–Meier survival analysis and Cox proportional hazard regression models were used to test the association between the CCP score and BCR. RESULTS Among the 100 men identified, 47(46.5%) had BCR. Five-year BCR-free survival for the vary low (<-1), low (<0), intermediate (0–1), high (>1) and vary high (>2) CCP score groups was 100%, 82.9%, 38.8%, 28.7%, 0% respectively (p<0.001). In multivariable models adjusting for clinical and pathological variables with the Cancer of the Prostate Risk Assessment (CAPRA) score, the CCP score was an independent predictor of BCR (HR:1.67; P = 0.001). In addition, CCP score had higher predictive accuracy for BPFS (increment in Harrell concordance index by 0.026–0.036), compared with the CAPRA score. CONCLUSIONS For the appropriate patient, depending on age, physical condition, patient desire, etc., could be a candidate for wait and see policy with low specimen CCP score, so to distinguish this from high CCP score may facilitate discussions at the point of treatment decision making. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e818 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Xun Shangguan More articles by this author Wei Xue More articles by this author Baijun Dong More articles by this author Jiahua Pan More articles by this author Hongyang Qian More articles by this author Fan Xu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...