The CAPRA&PDE4D5/7/9_BCR risk score was significantly associated with adverse post-surgical pathology independent of clinical risk metrics (p=0.04), yielding an 82.0% negative predictive value.
Cohort (n=84)
Does the CAPRA&PDE4D5/7/9_BCR risk score predict adverse post-surgical pathology outcomes in patients with low-intermediate risk prostate cancer?
The CAPRA&PDE4D5/7/9_BCR risk score significantly predicts adverse post-surgical pathology outcomes in low-intermediate risk prostate cancer patients, outperforming standard PRIAS criteria.
p-value: p=0.04
Objectives: To investigate the association of the prognostic risk score CAPRA of those n = 84 had low−intermediate clinical risk based on the CAPRA score and DRE clinical stage 2, or pathological pT stage > pT3a, or tumor penetrated prostate capsular status, or pN1 disease) ; (ii) any ISUP pathological Gleason >2; (iii) any ISUP pathological Gleason >1. In the n = 84 patients with low to intermediate clinical risk profiles, the clinical-genomics CAPRA and p = 0. 01, p = 0. 0002, p = 0. 01, respectively). The clinically used PRIAS criteria for the selection of low-risk candidate patients for active surveillance (AS) were not significantly associated with any of the three tested post-operative pathology outcomes (p = 0. 3, p = 0. 1, p = 0. 1, respectively). In multivariable analysis adjusted for the CAPRA score, the genomics PDE4D5/7/9BCR risk score remained significant for the outcomes of adverse pathology (p = 0. 04) and ISUP pathological Gleason >2 (p = 0. 004). The negative predictive value of the CAPRA&PDE4D5/7/9BCR risk score using the low-risk cut-off (0. 1) for the three pathological endpoints was 82. 0%, 100%, and 59. 1%, respectively for a selected low-risk cohort of n = 22 patients (26. 2% of the entire cohort) compared to 72. 1%, 94. 4%, and 55. 6% for n = 18 low-risk patients (21. 4% of the total cohort) selected based on the PRIAS inclusion criteria. Conclusion: In this study, we have shown that the previously reported clinical-genomics prostate cancer risk model CAPRA&PDE4D5/7/9BCR which was developed to predict biological outcomes after surgery of primary prostate cancer is also significantly associated with post-surgical pathology outcomes. The risk score predicts adverse pathology independent of the clinical risk metrics. Compared to clinically used active surveillance inclusion criteria, the clinical-genomics CAPRA&PDE4D5/7/9BCR risk model selects 22% (n = 8) more low-risk patients with higher negative predictive value to experience unfavorable post-operative pathology outcomes.
Gulliver et al. (Fri,) conducted a cohort in Prostate cancer (n=84). CAPRA&PDE4D5/7/9_BCR risk score vs. PRIAS criteria was evaluated on Adverse Pathology (any ISUP pathological Gleason grade >2, or pathological pT stage > pT3a, or tumor penetrated prostate capsular status, or pN1 disease) (p=0.04). The CAPRA&PDE4D5/7/9_BCR risk score was significantly associated with adverse post-surgical pathology independent of clinical risk metrics (p=0.04), yielding an 82.0% negative predictive value.