Comparison of the Prognostic Utility of the Cell Cycle Progression Score for Predicting Clinical Outcomes in African American and Non-African American Men with Localized Prostate Cancer
Comparison of the Prognostic Utility of the Cell Cycle Progression Score for Predicting Clinical Outcomes in African American and Non-African American Men with Localized Prostate Cancer
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DOI：
10.1016/j.eururo.2018.10.028
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发表时间：
2019-03-01
期刊：
影响因子：
23.4
通讯作者：
Bardot, Stephen
中科院分区：
文献类型：
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作者：
Canter, Daniel J.;Reid, Julia;Bardot, Stephen
背景资料：更好的前列腺癌风险分层是必要的，以告知医疗管理，特别是非洲裔美国人（AA）的男性，对他们来说，结果是特别不确定的。目的：评估细胞周期进展（CCP）评分和临床细胞周期风险（CCR）评分在预测AA患者人群中高度富集的前列腺癌男性大队列临床结局中的效用。和参与者：患者被诊断患有临床上局限的前列腺腺癌，并于2006年1月至2011年12月在Ochsner诊所（New Orleans，LA，USA）接受治疗。CCP评分来自存档的福尔马林固定、石蜡包埋的活检组织。CCR评分计算为分子（CCP评分）和临床（前列腺癌风险评估[CAPRA]评分）组成部分的组合。干预：积极治疗（根治性前列腺切除术，单独放射治疗，或放射和激素治疗）或观察等待。结果测量和统计分析：主要结果是转移性疾病的进展。通过考克斯比例风险生存分析和似然比tests.Results和局限性：最终队列包括767名男性，其中281人（36.6%）AA的结果进行了评估。在多变量分析中考虑了血统、治疗和CAPRA后，CCP评分仍然是转移性疾病的重要预测因子（风险比[HR] 2.04; p < 0.001），与血统（p = 0.20）或治疗（p = 0.09）没有相互作用。CCR评分具有高度预后性（HR 3.86; p < 0.001），与CCP评分一样，与血统（p = 0.24）或治疗（p = 0.32）无相互作用。局限性包括回顾性研究设计和使用自我报告的祖先information.Conclusions：CCR评分提供了显着的预后信息，无论祖先。研究结果表明，AA男性在这项研究队列似乎有类似的前列腺癌的结果，非AA患者后，占所有可用的分子和临床病理学variables.Patient摘要：在这项研究中，我们评估的能力相结合的分子和临床评分预测局部前列腺癌的进展。我们发现，无论患者的血统或治疗如何，结合分子和临床评分可预测转移进展。这表明，结合分子和临床评分可能是一个有价值的工具，用于确定新诊断的前列腺癌男性的转移风险，以便做出适当的治疗决定。(C)2018作者（S）由爱思唯尔公司出版
Background: Better prostate cancer risk stratification is necessary to inform medical management, especially for African American (AA) men, for whom outcomes are particularly uncertain.Objective: To evaluate the utility of both a cell cycle progression (CCP) score and a clinical cell-cycle risk (CCR) score to predict clinical outcomes in a large cohort of men with prostate cancer highly enriched in an AA patient population.Design, setting, and participants: Patients were diagnosed with clinically localized adenocarcinoma of the prostate and treated at The Ochsner Clinic (New Orleans, LA, USA) from January 2006 to December 2011. CCP scores were derived from archival formalin-fixed, paraffin-embedded biopsy tissue. CCR scores were calculated as the combination of molecular (CCP score) and clinical (Cancer of the Prostate Risk Assessment [CAPRA] score) components.Intervention: Active treatment (radical prostatectomy, radiation therapy alone, or radiation and hormone therapy) or watchful waiting.Outcome measurements and statistical analysis: The primary outcome was progression to metastatic disease. Association with outcomes was evaluated via Cox proportional hazards survival analysis and likelihood ratio tests.Results and limitations: The final cohort included 767 men, of whom 281 (36.6%) were AA. After accounting for ancestry, treatment, and CAPRA in multivariable analysis, the CCP score remained a significant predictor of metastatic disease (hazard ratio [HR] 2.04; p < 0.001), and there was no interaction with ancestry (p = 0.20) or treatment (p = 0.09). The CCR score was highly prognostic (HR 3.86; p < 0.001), and as with the CCP score, there was no interaction with ancestry (p = 0.24) or treatment (p = 0.32). Limitations include the retrospective study design and the use of self-reported ancestry information.Conclusions: A CCR score provided significant prognostic information regardless of ancestry. The findings demonstrate that AA men in this study cohort appear to have similar prostate cancer outcomes to non-AA patients after accounting for all available molecular and clinicopathologic variables.Patient summary: In this study we evaluated the ability of a combined molecular and clinical score to predict the progression of localized prostate cancer. We found that the combined molecular and clinical score predicted progression to metastasis regardless of patient ancestry or treatment. This suggests that the combined molecular and clinical score may be a valuable tool for determining the risk of metastasis in men with newly diagnosed prostate cancer in order to make appropriate treatment decisions. (C) 2018 The Author(s). Published by Elsevier B.V.