Prognostic Features of Near-Infrared Spectroscopy Following Primary Radical Prostatectomy.

Abstract

Simple SummaryUp to 53% of patients with localized/locally advanced prostate cancer (PCa) will be confronted with biochemical recurrence (BCR) at some point after primary radical prostatectomy. No robust prognostic biomarker exists in this patient setting. The aim of this retrospective study was therefore to determine if near-infrared (NIR) spectroscopy, an easy-to-use technique, could be an asset as a prognostic biomarker for PCa patients after radical prostatectomy. In a cohort of 82 patients, we confirmed that changes in the NIR spectrum of PCa specimens, obtained via radical prostatectomy, can be prognostic for BCR-free survival. The clinical implementation of NIR spectroscopy can therefore be a great asset as it can aid in the management of PCa patients following primary radical prostatectomy. Further elaboration is recommended.Background: Only a few biomarkers have been evaluated for their prognostic value with regard to biochemical recurrence (BCR) following primary radical prostatectomy. We explored the possibilities of using near-infrared (NIR) spectroscopy as a prognostic biomarker for BCR-free survival (BCR-FS). Methods: Tissue specimens from 82 prostate cancer patients were obtained. Formalin-fixed paraffin-embedded slides (hematoxylin–eosin-stained) were analyzed using NIR spectroscopy. Prognostic features for BCR-FS were determined following normalization of the spectra. Results: Several differences were found throughout the NIR spectrum for the patients with or without BCR, for both the first derivative and second derivative of the NIR spectrum. Following categorization and Cox regression analysis, spectral regions at 5236 cm−1 (first derivative; median BCR-FS not reached versus 3.2 years; HRhigh = 0.18 [0.08–0.39]; and p < 0.0001) and at 5956 cm−1 (second derivative; median BCR-FS not reached versus 3.8 years; HRlow = 0.22 [0.10–0.48]; and p = 0.0002) showed prognostic properties for BCR-FS. The combination of both parameters further increased the prognostic value of NIR (p < 0.0001). Conclusions: We demonstrated NIR spectral variations between patients with or without BCR, which have been shown to have prognostic value. This easy-to-use technique could possibly further improve post-primary radical prostatectomy monitoring and swift referral to adjuvant local therapies. Further elaboration is highly recommended to fully elucidate these variations and to gain a deeper insight into the changing chemical and physical compositions of the prostate tumor architecture.