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Does post prostatectomy decipher score predict biochemical recurrence and impact care?

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Abstract

Purpose

To examine the ability of the Decipher test to predict early biochemical recurrence after radical prostatectomy and to impact clinical decisions in advance of metastasis and death.

Methods

We identified Decipher tests ordered after radical prostatectomy for adverse pathology in men treated for prostate cancer between 1/1/14 and 8/31/18. Biochemical recurrence was defined as prostate-specific antigen > 0.02 ng/mL. Decipher score is reported as lower risk (< 0.6) and higher risk ≥ 0.60). Kaplan–Meier analysis was used to examine the relationship between Decipher score and time to biochemical recurrence (months). Cox regression was used to analyze the relationship between Decipher score and time to biochemical recurrence while controlling for a number of clinical characteristics. Secondary analyses focused on a subset of men with prostate-specific antigen > 0.02 and < 0.20 ng/mL to determine if high-risk Decipher scores were associated with receipt of salvage treatment.

Results

A total of 203 cases were analyzed: 37.9% and 62.1% had lower and higher risk Decipher scores respectively, and 56.2% had a biochemical recurrence. Median (inter-quartile range) follow-up was 20 (13.5, 25.3) months. Decipher score was significantly associated with time to biochemical recurrence (p = 0.027) while in the secondary analyses, high-risk Decipher scores (≥ 0.60) were associated with salvage treatment (p = 0.018). Stage category and Decipher score were significant predictors of time from elevated PSA to salvage treatment in the secondary analyses.

Conclusion

While it might not contribute statistically, Decipher score can be clinically useful in helping patients reach treatment decisions.

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Availability of data

Sharing of de-identified data with an external entity would require the approval of the Hartford Hospital IRB.

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Funding

This project did not receive financial support.

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Authors and Affiliations

  1. Urology Division, Hartford Healthcare Medical Group, Hartford Hospital, 85 Seymour Street, Suite 416, Hartford, CT, 06106, USA

    Christine White, Tara McLaughlin, Kevin Pinto, Akshay Gangakhedkar & Joseph Wagner

  2. Hartford Hospital Research Program, Hartford Hospital, Hartford, CT, 06106, USA

    Ilene Staff, Joseph Tortora & Alison Champagne

Authors
  1. Christine White
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  2. Ilene Staff
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  3. Tara McLaughlin
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  4. Joseph Tortora
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  5. Kevin Pinto
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  6. Akshay Gangakhedkar
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  7. Alison Champagne
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  8. Joseph Wagner
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Contributions

Protocol/project development: CW, JW, IS, TM; data collection and management: JT, KP, AG, AC; data analysis: IS; manuscript writing/editing: CW, IS, TM, JW, JT, KP, AG, AC; supervision: JW.

Corresponding author

Correspondence to Tara McLaughlin.

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Conflict of interest

JW serves on the speaker’s bureau for Genomic Health and as a consultant for Covidien.

Ethics approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Hartford Hospital Institutional Review Board (IRB) approved this study.

Consent to participate/consent for publication

The Hartford Hospital Institutional Review Board approved this study with a full waiver of consent.

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SPSS code could be made available upon request.

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White, C., Staff, I., McLaughlin, T. et al. Does post prostatectomy decipher score predict biochemical recurrence and impact care?. World J Urol 39, 3281–3286 (2021). https://doi.org/10.1007/s00345-021-03661-1

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  • DOI: https://doi.org/10.1007/s00345-021-03661-1

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