1293 PREVIOUSLY DEVELOPED SYSTEMS-BASED BIOPSY MODEL (PROSTATE PX+) IDENTIFIES FAVORABLE-RISK PROSTATE CANCER FOR MEN ENROLLED IN AN ACTIVE SURVEILLANCE PROGRAM (2011)

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111293 PREVIOUSLY DEVELOPED SYSTEMS-BASED BIOPSY MODEL (PROSTATE PX+) IDENTIFIES FAVORABLE-RISK PROSTATE CANCER FOR MEN ENROLLED IN AN ACTIVE SURVEILLANCE PROGRAM Michael Donovan, Faisal Khan, Douglas Powell, Gerardo Fernandez, Aaron Feliz, Thomas Hansen, Lourdes Bernardino, Paola Capodieci, Valentina Bayer-Zubek, Quihua Liu, Rav Vance, and Laurence Klotz Michael DonovanMichael Donovan Yonkers, NY More articles by this author , Faisal KhanFaisal Khan Yonkers, NY More articles by this author , Douglas PowellDouglas Powell Yonkers, NY More articles by this author , Gerardo FernandezGerardo Fernandez Yonkers, NY More articles by this author , Aaron FelizAaron Feliz Yonkers, NY More articles by this author , Thomas HansenThomas Hansen Yonkers, NY More articles by this author , Lourdes BernardinoLourdes Bernardino Yonkers, NY More articles by this author , Paola CapodieciPaola Capodieci Yonkers, NY More articles by this author , Valentina Bayer-ZubekValentina Bayer-Zubek Yonkers, NY More articles by this author , Quihua LiuQuihua Liu Yonkers, NY More articles by this author , Rav VanceRav Vance Norfolk, VA More articles by this author , and Laurence KlotzLaurence Klotz Tornoto, ON More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.993AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We previously developed two independent pre-treatment prostate cancer risk assessment (systems) models (Prostate Px+) using the patient's own prostate needle biopsy (PNB) specimen and 8-year median outcome data post radical prostatectomy. We sought to determine the performance of these disease progression models on predicting which patients enrolled in an active surveillance (AS) program are most likely to remain on AS or be treated, by evaluating predictors of disease progression including subsequent biopsy Gleason grade (GG) upgrading and time from AS enrollment to definitive treatment. METHODS 100 AS patients (median age 71 years, 92% cT1–T2a, 85% <=GS6, median PSA 6.2 ng/mL), with overall 8-year median follow up and available diagnostic PNB specimens were evaluated with our systems pathology platform as previously reported. Disease progression models predicting either GG upgrading on a subsequent biopsy or time to definitive treatment were evaluated. The AUC/concordance index (CI), PPV, NPV, and hazard ratio with p-value were used to assess models performance. RESULTS Utilizing existing model thresholds now applied to clinical endpoints of upgrading and treatment, the Prostate Px+ models were able to accurately identify which AS patients are most likely to not have a Gleason upgrade on a subsequent biopsy (AUC 0.73, NPV 0.86, PPV 0.60). In addition, we were able to predict with good accuracy which patients are at risk for requiring therapy while on AS (hazard ratio 3.4, p value 0.006). The correlation of Gleason rise with treatment had a chi-square of 16.45, p<0.001. CONCLUSIONS Prognostic systems-based models using the patient's own prostate NB specimen are able to accurately identify AS patients at risk for Gleason upgrading and / or requiring treatment while on protocol. Identifying such patients may enhance the primary treatment decision process. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e517-e518 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Donovan Yonkers, NY More articles by this author Faisal Khan Yonkers, NY More articles by this author Douglas Powell Yonkers, NY More articles by this author Gerardo Fernandez Yonkers, NY More articles by this author Aaron Feliz Yonkers, NY More articles by this author Thomas Hansen Yonkers, NY More articles by this author Lourdes Bernardino Yonkers, NY More articles by this author Paola Capodieci Yonkers, NY More articles by this author Valentina Bayer-Zubek Yonkers, NY More articles by this author Quihua Liu Yonkers, NY More articles by this author Rav Vance Norfolk, VA More articles by this author Laurence Klotz Tornoto, ON More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...