PD56-12 COMPARISON OF A LOW-COST IMMUNOHISTOCHEMISTRY MARKER PANEL WITH A CELL-CYCLE PROGRESSION ASSAY FOR THE PREDICTION OF OUTCOME AFTER RADICAL PROSTATECTOMY

You have accessJournal of UrologyProstate Cancer: Markers II1 Apr 2018PD56-12 COMPARISON OF A LOW-COST IMMUNOHISTOCHEMISTRY MARKER PANEL WITH A CELL-CYCLE PROGRESSION ASSAY FOR THE PREDICTION OF OUTCOME AFTER RADICAL PROSTATECTOMY Michael Leapman, Hao Nguyen, Janet Cowan, Lingru Xue, Bradley Stohr, Jeffry Simko, Matthew Cooperberg, and Peter Carroll Michael LeapmanMichael Leapman More articles by this author , Hao NguyenHao Nguyen More articles by this author , Janet CowanJanet Cowan More articles by this author , Lingru XueLingru Xue More articles by this author , Bradley StohrBradley Stohr More articles by this author , Jeffry SimkoJeffry Simko More articles by this author , Matthew CooperbergMatthew Cooperberg More articles by this author , and Peter CarrollPeter Carroll More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2644AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Gene expression assays appear to stratify prostate cancer risk, however tests involving amplification techniques are expensive and may strain payment systems. We aimed to compare the prognostic utility of a low-cost immunohistochemistry (IHC) panel consisting of three validated markers with an RNA expression based cell-cycle progression (CCP) score. METHODS Among 5,748 patients with PCa within an institutional database, we identified 424 with localized PCa treated with radical prostatectomy (RP). IHC analysis was performed using tissue microarrays to examine the expression status of PTEN, Ki67, and ERG compared with previously calculated CCP scores derived from 31 genes normalized to 15 housekeeper genes. Associations of IHC status, CCP scores, adjusted for clinical and pathologic characteristics (Cancer of the Prostate Risk Assessment Score, CAPRA-S) were performed using Cox proportional hazards regression to examine risk of biochemical recurrence (BCR), and metastasis or PCa- specific mortality (PCSM). We compared model discrimination using concordance index (c-index) testing. RESULTS The median age at treatment was 59 years and patients were followed for a median of 114 months post RP. By 10 years after RP, 27% experienced BCR and 4% developed metastasis or PCSM. Adjusted for CAPRA-S, PTEN loss was independently associated with risk of metastasis/PCSM (HR 5.39, 95% CI 2.56-11.4), but not BCR. CCP score remained an independent predictor of metastasis/PCSM and recurrence (HR 2.24, 95% CI 1.40-3.59, and HR 1.91, 95% CI 1.47-2.48, respectively) in models including CAPRA-S. The c-index for the model including PTEN status and CAPRA-S was slightly higher (0.78) for the prediction of metastasis or PCSM than a model including CAPRA-S and CCP (0.76). Ki67 or ERG expression were not significant independent predictors of outcome and did not improve the c-index relative to CAPRA-S and PTEN status. CONCLUSIONS Integration of PTEN status with clinical and pathologic features offered slightly improved discrimination of the risk of metastasis or PCSM when compared with a CCP assay. Efforts are warranted to reduce the cost of PCa prognostic tools in order to expand access. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1066 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Michael Leapman More articles by this author Hao Nguyen More articles by this author Janet Cowan More articles by this author Lingru Xue More articles by this author Bradley Stohr More articles by this author Jeffry Simko More articles by this author Matthew Cooperberg More articles by this author Peter Carroll More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...