Quantified Clinical Risk Change as an End Point During Prostate Cancer Active Surveillance

Leapman, Michael; Ameli, Niloufar; Cooperberg, Matthew R.; Chu, Carissa; Hussein, Ahmed A.; Shinohara, Katsuto; Carroll, Peter R.

doi:10.1016/j.eururo.2016.04.021

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…A higher incidence of short-term reclassification was also reported in studies of patients receiving genomic testing that may relate to the preferential use of genomic testing in higher-risk populations [26] . In addition, we defined biopsy upgrading as any increase in biopsy Gleason score, an approach used in prior studies, but this may fail to account for more substantial changes in risk such as a simultaneous increase in tumor volume [27] . Although all prostate MRI scans were reviewed by expert genitourinary radiologists at our institution, central re-review of scans to apply the PRECISE criteria for MRI progression [28] was not conducted for this study.…”

Section: Discussionmentioning

confidence: 99%

Association Between a 22-feature Genomic Classifier and Biopsy Gleason Upgrade During Active Surveillance for Prostate Cancer

Press

Jones

Olawoyin

et al. 2022

European Urology Open Science

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Section: Discussionmentioning

confidence: 99%

Association Between a 22-feature Genomic Classifier and Biopsy Gleason Upgrade During Active Surveillance for Prostate Cancer

Press

Jones

Olawoyin

et al. 2022

European Urology Open Science

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“…29 In addition, we defined biopsy upgrade as any increase in biopsy Gleason score, an approach used in prior studies, but this may fail to account for more substantial changes of risk such as a simultaneous increase in tumor volume. 30 In addition, although all prostate MRI studies were reviewed by expert genitourinary radiologists at our institution, a central re-review of studies was not conducted for this study to apply the PRECISE criteria for MRI progression. 31 Lastly, although this work addresses biopsy upgrading, there is an insufficient sample size and follow-up to assess the meaningful distant longitudinal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Association Between a 22-feature Genomic Classifier and Biopsy Gleason Upgrade During Active Surveillance for Prostate Cancer

Press¹,

Jones²,

Olawoyin³

et al. 2021

Preprint

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BackgroundAlthough the Decipher genomic classifier has been validated as a prognostic tool for several prostate cancer endpoints, little is known about its role in assessing risks of biopsy reclassification among patients on active surveillance, a key event that often triggers treatment.ObjectiveTo evaluate the association between Decipher genomic classifier and biopsy Gleason upgrade among patients on active surveillance.Design, Setting, and ParticipantsRetrospective cohort study among patients with low- and favorable-intermediate-risk prostate cancer on active surveillance who underwent biopsy-based Decipher testing as part of clinical care.Outcomes measures and statistical analysisAny increase in biopsy Gleason grade group (GG). We evaluated the association between Decipher score using univariable and multivariable logistic regression. We compared area under the receiver operating characteristic curve (AUC) of models comprised of baseline clinical variables with or without Decipher score.Results and limitationsWe identified 133 patients of median age 67.7 years and median PSA 5.6 ng/mL. At enrollment 75.9% were GG1 and 24.1 GG2. Forty-three patients experienced biopsy upgrade. On multivariable logistic regression, Decipher score was significantly associated with biopsy upgrade (OR 1.37 per 0.10 unit increase, 95% CI 1.05-1.79 p=0.02). Decipher score was associated with upgrade among patients with biopsy Grade group 1, but not Grade Group 2 disease. The discriminative ability of a clinical model (AUC 0.63, 95% CI 0.51-0.74) was improved with the integration of Decipher score (AUC 0.69, 95% CI 0.58-0.80).ConclusionsThe Decipher genomic classifier was associated with short-term biopsy Gleason upgrading among patients on active surveillance.Patient summaryThe results from this study indicate that among patients with prostate cancer undergoing active surveillance, those with higher Decipher scores were more likely to have higher-grade disease found over time. These findings indicate that the Decipher test might be useful for guiding the intensity of monitoring during active surveillance.

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“…However, the vast majority (89.6%) had "minor" downgrading and harbored GS 7 PCa at RP, whereas only 10.4% had "major" downgrading and harbored GS 6 at RP. The latter small proportion of patients might have been precluded from less invasive treatment, such as active surveillance (AS), despite the use of a contemporary risk stratification tool (CAPRA) [22]. However, it is noteworthy that neither CAPRA nor CAPRA-S LR is a validated criterion for AS or insignificant PCa (iPCa).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Oncological Outcomes After Radical Prostatectomy According to Preoperative and Postoperative Cancer of the Prostate Risk Assessment Scores: Results from a Large, Two-center Experience

Leyh-Bannurah

Dell’Oglio

Zaffuto

et al. 2019

European Urology Focus

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Quantified Clinical Risk Change as an End Point During Prostate Cancer Active Surveillance

Cited by 9 publications

References 8 publications

Association Between a 22-feature Genomic Classifier and Biopsy Gleason Upgrade During Active Surveillance for Prostate Cancer

Association Between a 22-feature Genomic Classifier and Biopsy Gleason Upgrade During Active Surveillance for Prostate Cancer

Association Between a 22-feature Genomic Classifier and Biopsy Gleason Upgrade During Active Surveillance for Prostate Cancer

Assessment of Oncological Outcomes After Radical Prostatectomy According to Preoperative and Postoperative Cancer of the Prostate Risk Assessment Scores: Results from a Large, Two-center Experience

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