2242 PROGNOSTIC UTILITY OF CCP SCORE IN MEN WITH PROSTATE CANCER AFTER PRIMARY EXTERNAL BEAM RADIATION THERAPY (2013)

You have accessJournal of UrologyProstate Cancer: Markers (II)1 Apr 20132242 PROGNOSTIC UTILITY OF CCP SCORE IN MEN WITH PROSTATE CANCER AFTER PRIMARY EXTERNAL BEAM RADIATION THERAPY Stephen Freedland, Leah Gerber, Julia Reid, William Welbourn, Eliso Tikishvili, Jimmy Park, Abid Younus, Alexander Gutin, Zaina Sangale, Jerry Lanchbury, Joseph Salama, and Steven Stone Stephen FreedlandStephen Freedland Durham, NC More articles by this author , Leah GerberLeah Gerber Durham, NC More articles by this author , Julia ReidJulia Reid Salt Lake City, UT More articles by this author , William WelbournWilliam Welbourn Salt Lake City, UT More articles by this author , Eliso TikishviliEliso Tikishvili Salt Lake City, UT More articles by this author , Jimmy ParkJimmy Park Salt Lake City, UT More articles by this author , Abid YounusAbid Younus Salt Lake City, UT More articles by this author , Alexander GutinAlexander Gutin Salt Lake City, UT More articles by this author , Zaina SangaleZaina Sangale Salt Lake City, UT More articles by this author , Jerry LanchburyJerry Lanchbury Salt Lake City, UT More articles by this author , Joseph SalamaJoseph Salama Durham, NC More articles by this author , and Steven StoneSteven Stone Salt Lake City, UT More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2151AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Accurate risk stratification improves decision making in localized prostate cancer. The CCP score, a prognostic RNA signature based on the average expression level of 31 cell cycle progression (CCP) genes, was developed to aid in this task. Previously, the CCP score was shown to be predictive of biochemical recurrence (BCR) after prostatectomy, and prostate cancer specific mortality in men undergoing observation. However, the value of CCP score in men undergoing primary electron beam radiation therapy (EBRT) was untested. METHODS The CCP score was derived retrospectively from the diagnostic biopsy of 141 patients treated with EBRT at the Durham VA medical Center. Inclusion criteria were disease diagnosis from 1991 to 2006 and available biopsy tissue. Approximately half of the cohort was African-American. Outcome was time from EBRT to BCR using Phoenix definition, and median follow-up for patients without BCR was 4.8 years. Association with outcome was evaluated by CoxPH survival analysis and likelihood ratio tests. RESULTS Patient data were censored at 5-years of follow-up and 19 patients (13%) had BCR. The median CCP score was 0.12(IQR -0.43 to 0.66). In univariable analysis, CCP score was a significant prognostic variable (p-value = 0.0017). The hazard ratio (HR) for BCR was 2.55 (95% CI (1.43, 4.55)) for a one-unit increase in CCP score (equivalent to a doubling of gene expression). In a predefined multivariable analysis that included Gleason score, PSA, and percent positive cores, the HR for CCP changed only marginally and remained significant (HR per CCP unit 2.09 (95% CI (1.05, 4.18), p-value = 0.035), indicating that CCP provides prognostic information that is not provided by standard clinical parameters. Further adjustment for hormonal therapy or radiation dose did not materially alter this association. The score was also associated with prostate cancer specific mortality. There was no evidence for interaction between CCP and any clinical variable, including ethnicity. CONCLUSIONS In a cohort of men treated with EBRT, the CCP score was significantly associated with outcome and provided prognostic information beyond what was available from clinical parameters. If validated in a larger cohort, CCP score could be used to select high-risk men undergoing EBRT who may need combination therapy for their clinically localized prostate cancer. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e919 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephen Freedland Durham, NC More articles by this author Leah Gerber Durham, NC More articles by this author Julia Reid Salt Lake City, UT More articles by this author William Welbourn Salt Lake City, UT More articles by this author Eliso Tikishvili Salt Lake City, UT More articles by this author Jimmy Park Salt Lake City, UT More articles by this author Abid Younus Salt Lake City, UT More articles by this author Alexander Gutin Salt Lake City, UT More articles by this author Zaina Sangale Salt Lake City, UT More articles by this author Jerry Lanchbury Salt Lake City, UT More articles by this author Joseph Salama Durham, NC More articles by this author Steven Stone Salt Lake City, UT More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...