1. Validation of a Genomic Risk Classifier to Predict Prostate Cancer-specific Mortality in Men with Adverse Pathologic Features
- Author
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Karnes, R Jeffrey, Choeurng, Voleak, Ross, Ashley E, Schaeffer, Edward M, Klein, Eric A, Freedland, Stephen J, Erho, Nicholas, Yousefi, Kasra, Takhar, Mandeep, Davicioni, Elai, Cooperberg, Matthew R, and Trock, Bruce J
- Subjects
Male ,Prostate cancer-specific mortality ,Urologic Diseases ,Aging ,Adverse pathologic features ,Prostate Cancer ,Human Genome ,Clinical Sciences ,Prostatic Neoplasms ,Genomics ,Middle Aged ,Urology & Nephrology ,Prognosis ,Risk Assessment ,Radical prostatectomy ,CAPRA-S ,Good Health and Well Being ,Clinical Research ,Genomic classifier ,Genetics ,Humans ,Patient Safety ,Aged ,Cancer - Abstract
BackgroundRisk of prostate cancer-specific mortality (PCSM) is highly variable for men with adverse pathologic features at radical prostatectomy (RP); a majority will die of other causes. Accurately stratifying PCSM risk can improve therapy decisions.ObjectiveValidate the 22 gene Decipher genomic classifier (GC) to predict PCSM in men with adverse pathologic features after RP.Design, setting, and participantsMen with adverse pathologic features: pT3, pN1, positive margins, or Gleason score >7 who underwent RP in 1987-2010 at Johns Hopkins, Cleveland Clinic, Mayo Clinic, and Durham Veteran's Affairs Hospital. We also analyzed subgroups at high risk (prostate-specific antigen >20 ng/ml, RP Gleason score 8-10, or stage >pT3b), or very high risk of PCSM (biochemical recurrence in 0.6) versus low-intermediate (≤ 0.6), the odds ratio for PCSM10 adjusted for CAPRA-S was 3.91 (95% confidence interval: 2.43-6.29), with AUC=0.77, an increase of 0.04 compared with CAPRA-S. Subgroup odds ratios were 3.96, 3.06, and 1.95 for high risk, BCR2, or MET, respectively (all p
- Published
- 2018