Login to Access Video or Poster Abstract: MP20-04
Sources of Funding: None

Introduction

In the post-USPSTF era, the decision to identify and treat prostate cancer (PCa) remains controversial. The Decipher Prostate Cancer Classifier (DPCC) is a genomic test that independently predicts the risk of metastasis and prostate cancer specific mortality (PCSM). The studies used to validate the outcomes of the DPCC were comprised of mostly Caucasian men. Given the increased risk of PCSM in African American (AA) men, we sought to identify the utility of DPCC in an exclusively AA cohort and compare the results to previously well-established risk classification systems.

Methods

Using an IRB-approved single institution database, we identified 72 AA men who had undergone radical prostatectomy between December 2008 and April 2016 for whom the DPCC was retrospectively ordered. Clinicopathologic variables were then used to risk stratify the patients based on the D'Amico and CAPRA-S risk classification systems. Comparisons were made to the DPCC risk scores based on low, intermediate, and high risk using a Chi-square analysis.

Results

In this AA cohort, there was no association between DPCC risk scores and CAPRA-S scores (p = 0.24). There was a relationship trend between DPCC risk scores and D'Amico risk categories, but this finding was not statistically significant (p = 0.08). Among those with a low CAPRA-S and D'Amico risk, DPCC re-classified 28.6% and 12.5% of these men into a high risk category, respectively. Conversely, among men with combined intermediate and high CAPRA-S and D'Amico risk, 43.1% and 39.3% were re-classified as low risk based on DPCC, respectively.

Conclusions

In this exclusive AA cohort, DPCC risk groups do not correlate with the CAPRA-S or D'Amico risk classification systems, which calls into question the clinical validity of these tools when counseling AA men. Prospective studies are needed to determine the true correlation of DPCC risk and cancer outcomes in this high risk subpopulation to better inform management decisions.

Funding

None