Abstract
Objective
To assess the use of the cell cycle progression (CCP) score versus actual risk stratification practice in making treatment decisions for prostate cancer patients with locally adverse pathology after radical prostatectomy (RP).
Patients and methods
Men with adverse pathologic features, pT3 or positive surgical margins who underwent RP in 2010–2014 at Renji hospital were retrospectively analyzed. The primary outcome was biochemical recurrence (BCR) after RP. RNA was quantified from paraffin-embedded RP specimens. The CCP score was calculated as average expression of 31 CCP genes, normalized to 15 housekeeper genes. The prognostic utility of the CCP score was assessed using Kaplan–Meier analysis and multivariable Cox proportional hazards model.
Results
Among the 100 men identified, 5-year BCR-free survival for the low- (< 0), intermediate- (0–1) and high- (> 1) CCP score groups was 89.3%, 38.8%, and 12.9%, respectively. In multivariable models adjusting for clinical and pathological variables with the cancer of the prostate risk assessment post-surgical (CAPRA-S) score, both continuous CCP score [hazard ratio (HR) 1.373 per unit score, 95% confidence interval (CI) 1.006–1.874; p = 0.046) and the categorized CCP score (p < 0.001)were independent predictors of BCR.
Conclusions
The present study provides insights into the role the CCP score plays in risk stratification of this cohort and in determining candidacy for deferred secondary treatment. From our perspective, the CCP score allows better stratification and can help identifying patients at lower risk of disease recurrence who could benefit from a wait-and-see policy.
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Acknowledgements
This study was supported by National Natural Science Foundation of China (Grant numbers: 81572536, 81672850), Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (Grant number: 20152215). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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XS and HQ: protocol/project development, data collection or management, data analysis, manuscript writing/editing. ZJ: data collection or management, data analysis. ZX: data analysis. JP: data collection or management. BD and WX: protocol/project development, data analysis, manuscript writing/editing
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Shangguan, X., Qian, H., Jiang, Z. et al. Cell cycle progression score improves risk stratification in prostate cancer patients with adverse pathology after radical prostatectomy. J Cancer Res Clin Oncol 146, 687–694 (2020). https://doi.org/10.1007/s00432-019-03089-6
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DOI: https://doi.org/10.1007/s00432-019-03089-6