Utilization of a Genomic Classifier for Prediction of Metastasis Following Salvage Radiation Therapy after Radical Prostatectomy

摘要: Abstract Background Despite salvage radiation therapy (SRT) for recurrent prostate cancer (PCa) after radical prostatectomy (RP), some patients still progress to metastases. Identifying these men would allow them undergo systemic including testing novel therapies reduce metastases risk. Objective To test whether the genomic classifier (GC) predicts development of metastatic disease. Design, setting, and participants Retrospective multi-center multi-ethnic cohort study from two academic centers one Veterans Affairs Medical Center in United States involving 170 receiving SRT PCa post-RP. Outcome measurements statistical analysis Time disease tested using Cox regression, survival c-index, decision curve analysis. Performance GC was compared Cancer Prostate Risk Assessment Score Briganti risk models based on metrics. Results limitations With a median 5.7 yr follow-up SRT, 20 (12%) developed On multivariable analysis, each 0.1 unit increase (scaled 0 1), hazard ratio metastasis 1.58 (95% confidence interval 1.16–2.17; p =0.002). Adjusting androgen deprivation did not materially change results. The c-index 0.85 0.73–0.88) versus 0.63–0.65 published clinico-pathologic models. 5-yr cumulative incidence post-SRT with low, intermediate, high scores 2.7%, 8.4%, 33.1%, respectively ( Conclusions While validation larger, prospectively collected cohorts is required, data suggest strong predictor among post-RP, accurately identifying who are excellent candidates due their very high-risk Patient summary Genomic were evaluated ability predict cancer. able identify further