Login to Access Video or Poster Abstract: MP28-13
Sources of Funding: none

Introduction

Previous studies have demonstrated that the cell cycle progression (CCP) score measured in prostate biopsy specimens was predictive of several clinical outcomes. However, it is currently unclear whether the CCP score improves clinical risk stratification within Gleason score (GS) 6 cancers and the subset of patients with National Comprehensive Cancer Network (NCCN) low-risk disease. Therefore, our objective was to determine the prognostic utility of the CCP score in men with NCCN low-risk disease who underwent radical prostatectomy (RP).

Methods

Patients who underwent RP for GS ≤6 prostate cancer at three institutions (Martini Clinic [MC], Durham Veterans Affairs Medical Center [DVA], and Intermountain Healthcare [IHC]) were identified. The CCP score was obtained from diagnostic (DVA, IHC) or simulated biopsies (MC). Primary outcome was biochemical recurrence (BCR, PSA≥0.2 ng/ml) after RP. Prognostic utility of the CCP score was assessed using Kaplan-Meier analysis and multivariable Cox proportional hazards models in the subset of men meeting NCCN low-risk criteria and the overall cohort (all GS ≤6 prostate cancer patients).

Results

Among the 236 patients identified, 80% (188/236) met NCCN low-risk criteria. Five-year BCR-free survival for the low (<0), intermediate (0-1), and high (>1) CCP score groups was 89.2%, 80.4%, 64.7%, respectively in the low-risk cohort (log-rank p=0.027), and 85.9%, 79.1%, 63.1% respectively in the overall cohort (log-rank p=0.041). In multivariable models adjusting for clinical and pathological variables with the CAPRA score, the CCP score was an independent predictor of BCR in the low-risk (HR=1.77 per unit score, 95%CI [1.21, 2.58], p=0.003) and overall cohorts (HR=1.41 per unit score, 95%CI [1.02, 1.96], p=0.039).

Conclusions

In a cohort of NCCN low-risk patients, the CCP score improved clinical risk stratification of patients at increased risk of BCR. This suggests the CCP score could help improve the assessment of candidacy for active surveillance and guide optimal treatment selection in patients with NCCN low-risk prostate cancer.

Funding

none