Combining CAPRA-S With Tumor IDC/C Features Improves the Prognostication of Biochemical Recurrence in Prostate Cancer Patients |
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| Institution: | 1. Lunenfeld-Tanenbaum Research Institute, Sinai Health Systems, Toronto, Ontario, Canada;2. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada;3. Department of Laboratory Medicine and Pathobiology, University of Toronto Toronto, Toronto, Ontario, Canada;4. Departments of Surgery and Surgical Oncology, Division of Urology, University Health Network Toronto, Ontario, Canada;5. Faculty of Medicine and Health Technology, Tampere University and Tays Center, Tampere University Hospital, Tampere, Finland;6. Fimlab Laboratories Ltd, Tampere University Hospital, Tampere, Finland;7. Department of Pathology and Laboratory Medicine, University Health Network;1. Department of Urology, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy;2. Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland;3. Department of Urology, Spedali Civili of Brescia, Brescia, Italy;4. Department of Medical Oncology, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy;5. Clinica Luganese Moncucco, Lugano, Switzerland;6. Clinica S.Anna, Swiss Medical Group, Sorengo, Switzerland;7. Clinica Santa Chiara, Locarno, Switzerland;8. Department of Urology, CHU-Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse, France;9. Department of Urology, La Croix du Sud Hospital, Toulouse, France;10. Division of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Torino School of Medicine, Torino, Italy;11. GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, Sorbonne University, PARIS, France;12. Department of Urology, Bichat Hospital, Paris Descartes University, Paris, France;13. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria;14. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan;15. The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan;16. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia;17. Department of Urology, Weill Cornell Medical College, New York, NY;18. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX;19. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic;1. Department of Urology, Bundang Jesaeng General Hospital, Seongnam, Korea;2. Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea;3. Department of Urology, Ajou University School of medicine, Suwon, Korea;1. Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria;2. Department of Urology, University Hospital Zurich, Zurich, Switzerland;3. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;4. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan;5. Department of Urology, Medical University of Silesia, Zabrze, Poland;6. Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia;7. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia;8. Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan;9. Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland;10. Department of Urology Bichat Hospital, Paris Descartes University, Paris, France;11. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX;12. Department of Special Surgery, Division of Urology, Jordan University Hospital, The University of Jordan, Amman, Jordan;13. Department of Urology, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy;14. Department of Urology, University of Brescia, Spedali Civili di Brescia, Brescia, Italy;15. Department of Urology, Semmelweis University, Budapest, Hungary;16. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada;17. Department of Urology, Weill Cornell Medical College, New York, NY;18. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech;19. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria;20. European Association of Urology Research Foundation, Arnhem, The Netherlands;1. Department of Urology, Wakayama Medical University, Wakayama, Japan;2. Department of Urology, Kinan Hospital, Wakayama, Japan;3. Department of Urology, Rinku General Medical Center, Osaka, Japan;1. Department of Urology, University of Virginia, Charlottesville, VA;2. Department of Urology, University of Texas Health at San Antonio, San Antonio, TX;3. Department of Pathology and Laboratory Medicine, University of Texas Health at San Antonio, San Antonio, TX;4. Department of Urology, Doctor''s Hospital Renaissance, Edinberg, TX;1. Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada;2. Division of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada;3. Division of Medical Oncology, British Columbia Cancer Agency and the University of British Columbia, Vancouver, British Columbia, Canada;4. Department of Medical Oncology, University of Calgary and Tom Baker Cancer Centre, Calgary, Alberta, Canada;5. Department of Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada;6. CancerCare Manitoba, Winnipeg, Manitoba, Canada;7. Division of Medical Oncology/Hematology, Le Centre hospitalier de l''Université de Montréal, Montréal, Québec, Canada;8. Division of Medical Oncology, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, Ontario, Canada;9. Juravinski Cancer Centre and McMaster University, Hamilton, Ontario, Canada;10. Centre Hospitalier Universitaire de Québec, Université Laval, Québec City, Québec, Canada;11. Division of Medical Oncology/Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada;12. Department of Medicine, Hematology Service and Department of Oncology, Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montréal, Québec, Canada;13. Division of Urology, Department of Surgery, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada;14. Division of Urology, McMaster University, Hamilton, Ontario, Canada |
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| Abstract: | Background: Intraductal carcinoma and cribriform (IDC/C) tumor features are well-established prognosticators of biochemical recurrence (BCR), metastasis, and prostate cancer (PCa)-specific mortality. However, approximately 70% of PCa patients undergoing a radical prostatectomy are IDC/C negative, yet up-to 20% of these patients progress and experience BCR. Thus, tumor histopathologic characteristics such as IDC/C alone are limited in their ability to predict disease progression. Conversely, several nomograms such as Cancer of the Prostate Risk Assessment-Surgery (CAPRA-S) have been developed to aid in the prognostication of BCR, but not yet widely applied in clinical settings. Materials and methods: In this study, we assessed the combined prognostic utility of IDC/C, and CAPRA-S for BCR in 3 PCa patient cohorts. Results: CAPRA-S+IDC/C improved the predictive accuracy of BCR in all 3 cohorts (P < .001). Specifically, among IDC/C negative cases, CAPRA-S improved the prognostication of BCR in low-risk (Cohort 1; P < .001, Cohort 2; P < .001, Cohort 3; P = .003), intermediate (Cohort 1; P < .001, Cohort 2; P = .006, Cohort 3; P = .03) and high-risk (Cohort 1-3; P < .001) patients. Conversely, IDC/C improved the prognostication of BCR among CAPRA-S low-risk (Cohorts 1; P < .001 and Cohort 3; P = .003) patients. Conclusion: Our results suggest the investigation of histopathological IDC/C features in CAPRA-S low-risk patients and conversely, nomogram CAPRA-S among IDC/C negative patients improves the identification of patients likely to experience BCR, which would otherwise be missed through current assessment regimens. These patients can be offered more intensive monitoring and adjuvant therapies upfront to circumvent the development of recurrent cancer or overtreatment at the time of surgery. |
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| Keywords: | prostate cancer Biochemical Recurrence nomograms intraductal carcinoma Cribiform architecture IDC/C"} {"#name":"keyword" "$":{"id":"pc_sWgFJsyTdM"} "$$":[{"#name":"text" "_":"PCa CAPRA-S"} {"#name":"keyword" "$":{"id":"pc_f1G4YLf6t8"} "$$":[{"#name":"text" "_":"BCR GS"} {"#name":"keyword" "$":{"id":"pc_8n2sJW8OQo"} "$$":[{"#name":"text" "_":"GP GG"} {"#name":"keyword" "$":{"id":"pc_42SINZPvsd"} "$$":[{"#name":"text" "_":"PSA |
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