The CAPRA-S score versus subtypes of minimal residual disease to predict biochemical failure after radical prostatectomy

Abstract

Objective: The objective of this study was to compare the CAPRA-S score (based on clinicopathological findings) and the subtypes of minimal residual disease (MRD) (based on the biological properties of cancer cells) to predict biochemical failure (BF) after prostatectomy radical. Patients and methods: This was a prospective single-centre study of men who underwent radical prostatectomy. One month after surgery, the blood and bone marrow were taken for circulating prostate cell (CPC) and micrometastasis detection, identified using anti-PSA immunocytochemistry and defined as positive or negative. Patients were classified as Group A: CPC and micrometastasis negative, Group B: micrometastasis positive and CPC negative and Group C: CPC positive. CAPRA-S scores were classified as low, intermediate and high risk. Kaplan-Meier curves for biochemical failure-free survival (BFFS) and restricted mean survival time (RMST) to biochemical failure were determined and compared for up to 10 years. Results: 347 men participated with a median follow-up of 7 years, BFFS decreased proportionally with increasing CAPRA-S score and HR 1.13 and 1.65 for intermediate and high risk, respectively. After 10 years, the BFFS and RMST were 68%, 47% and 16% and 9, 7 and 6 years, respectively. The BFFS curves for MRD were not proportional; Group A and B BFFSs were similar up to 5 years, and then, there was an increasing failure in Group B patients After 10 years, the BFFS and RMST were 95%, 57% and 27% and 10, 9 and 6 years respectively. The CAPRA-S score failed to distinguish between Groups A and B, and one-third of high-risk Group C had low-risk CAPRA-S scores. MRD hazard ratios were Group B 1.76 and Group C 4.03. Research

Improvement in immune dysfunction after FOLFOX chemotherapy for Stage III colon cancer is associated with improved minimal residual disease prognostic subtype and outcome

“…androgen receptor variants in prostate cancer [32] and RAS/RAF in colon cancer patients [33]. The use of reverse polymerase chain reaction (PCR) or next-generation sequencing (NGS) of DNA is possible, such as RAS mutation analysis [34] in colon cancer and in metastatic breast cancer [35].…”

“…metalloproteinase-2 negative[27]. This has clinical implications, as patients with only bone marrow micrometastasis have a differing relapse pattern, being at risk for late relapse; in other words the period of dormancy from the end of treatment to relapse is much longer than in CTC positive patients in colon, prostate and breast cancer[22,32,39]. Although bone marrow sampling may be considered mune response to eliminate them.…”