MP53-11 THE DECIPHER PROSTATE CANCER CLASSIFIER CORRELATES WITH CAPRA-S IN A HIGH RISK GROUP OF AFRICAN AMERICAN AND CAUCASIAN PATIENTS

You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2018MP53-11 THE DECIPHER PROSTATE CANCER CLASSIFIER CORRELATES WITH CAPRA-S IN A HIGH RISK GROUP OF AFRICAN AMERICAN AND CAUCASIAN PATIENTS Jordan Alger, Matthew Beamer, Ramy Gadalla, Hanaa Nissim, Lambros Stamatakis, Ross Krasnow, Keith Kowalczyk, and Jonathan Hwang Jordan AlgerJordan Alger More articles by this author , Matthew BeamerMatthew Beamer More articles by this author , Ramy GadallaRamy Gadalla More articles by this author , Hanaa NissimHanaa Nissim More articles by this author , Lambros StamatakisLambros Stamatakis More articles by this author , Ross KrasnowRoss Krasnow More articles by this author , Keith KowalczykKeith Kowalczyk More articles by this author , and Jonathan HwangJonathan Hwang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1682AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatment decisions following radical prostatectomy (RP) can be challenging for prostate cancer (PCa) patients and providers. To address this, clinicopathologic (CP) risk classification systems such as CAPRA-S and D'Amico as well as the Decipher Prostate Cancer Classifier (DPCC) have been devised to better identify candidates for adjuvant therapy. Since African-Americans (AA) have a higher risk of developing aggressive PCa relative to Caucasians (CA), we sought to determine whether CAPRA-S and D'Amico correlate with DPCC scores in both ethnic groups and if ethnicity independently predicts DPCC risk. METHODS We used an IRB-approved database to select 110 AA and 53 CA patients who had undergone RP and were considered high risk for PCa recurrence based on surgical pathology (e.g. positive margins, EPE, SV invasion) between December 2008 and September 2017 at a single healthcare network. The DPCC was ordered for all prostate specimens and CP variables obtained from the electronic medical records (EMR) were used to stratify patients based on CAPRA-S and D'Amico risk classification. Spearman correlations (SC) were calculated to compare CAPRA-S and D'Amico with DPCC 5-year risk of metastasis for both AA and CA. The significance level was 0.05. RESULTS AA were significantly more likely than CA to have higher preoperative PSA (median 7.3 ng/dL vs 6.4 ng/dL, p=0.046), higher pathologic T stage (p=0.019), and SV invasion (20.9% vs 5.7%, p=0.012). Conversely, AA were significantly less likely than CA to have positive surgical margins (55.5% vs 83%, p<0.001) and had lower 5-year risk of metastasis (median 5% vs 10.8%, p=0.048). Significant positive correlations between CAPRA-S and DPCC (SC=0.42, p=0.002) and D'Amico and DPCC (SC=0.34, p=0.013) were observed for CA patients while only the CAPRA-S and DPCC positive correlation was significant in AA patients (SC=0.27, p=0.004). After adjusting for CAPRA-S and age on multivariate analysis, patients with high DPCC were more likely to be CA (OR 2.68, 95% CI 1.23-6.08; p=0.015). CONCLUSIONS For AA and CA patients, CAPRA-S correlates with DPCC 5-year risk of metastasis. Interestingly, while CA patients were more likely to have lower preoperative PSA, pathologic T stage, and rates of SV invasion, they were more likely to have positive surgical margins, higher 5-year risk of metastasis, and high risk DPCC scores. These unexpected results may reflect differences in prostate cancer screening, management, and referral patterns between AA and CA patients at high-volume centers and warrant further investigation. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e708 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jordan Alger More articles by this author Matthew Beamer More articles by this author Ramy Gadalla More articles by this author Hanaa Nissim More articles by this author Lambros Stamatakis More articles by this author Ross Krasnow More articles by this author Keith Kowalczyk More articles by this author Jonathan Hwang More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...