Decipher Genomic Classifier Measured on Prostate Biopsy Predicts Metastasis Risk

详细信息    查看全文

• 作者：Eric A. Klein^a ; ^{kleine@ccf.org" class="auth_mail" title="E-mail the corresponding author} ; Zaid Haddad^b ; Kasra Yousefi^b ; Lucia L.C. Lam^b ; Qiqi Wang^b ; Voleak Choeurng^b ; Beatrix Palmer-Aronsten^b ; Christine Buerki^b ; Elai Davicioni^b ; Jianbo Li^c ; Michael W. Kattan^c ; Andrew J. Stephenson^a ; Cristina Magi-Galluzzi^d
• 刊名：Urology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：90
• 期：Complete
• 页码：148-152
• 全文大小：562 K

文摘

To evaluate the ability of the Decipher genomic classifier in predicting metastasis from analysis of prostate needle biopsy diagnostic tumor tissue specimens.

Materials and Methods

Fifty-seven patients with available biopsy specimens were identified from a cohort of 169 men treated with radical prostatectomy in a previously reported Decipher validation study at Cleveland Clinic. A Cox multivariable proportional hazards model and survival C-index were used to evaluate the performance of Decipher.

Results

With a median follow up of 8 years, 8 patients metastasized and 3 died of prostate cancer. The Decipher plus National Comprehensive Cancer Network (NCCN) model had an improved C-index of 0.88 (95% confidence interval [CI] 0.77-0.96) compared to NCCN alone (C-index 0.75, 95% CI 0.64-0.87). On multivariable analysis, Decipher was the only significant predictor of metastasis when adjusting for age, preoperative prostate-specific antigen and biopsy Gleason score (Decipher hazard ratio per 10% increase 1.72, 95% CI 1.07-2.81, P = .02).

Conclusion

Biopsy Decipher predicted the risk of metastasis at 10 years post radical prostatectomy. While further validation is required on larger cohorts, preoperative knowledge of Decipher risk derived from biopsy could indicate the need for multimodality therapy and help set patient expectations of therapeutic burden.