Genomic Analysis And Clinical Outcomes Of Primary Gleason Pattern 5 (Pg5) Prostate Cancer (Pca) Treated With Radical Prostatectomy (Rp).

54Background: PG5 (5+5 and 5+4) PCa is historically associated with poor clinical outcomes such as progression to metastatic disease, poor response to androgen deprivation therapy (ADT) and short survival. To characterize the clinical features and biology of this aggressive type of PCa, we studied patients with PG5 who underwent a RP. Methods: Patients with surgical PG5 who underwent RP for localized PCa at Johns Hopkins Hospital were retrospectively studied. Pathological staging, tumor genomic data by Next Generation Sequencing (NGS), and PTEN and TP53 by IHC were correlated with clinical outcomes, such as biochemical relapse (BCR), metastasis-free survival (MFS), time to castration-resistance (TCR) and overall survival (OS). Fisher’s test and Kaplan-Meier were used for statistical analysis. Results: 60 pts, 90% pT3-4, 26% pN1, 46% R+, 90% seminal vesicle invasion (SVI) had a median follow up of 9 years. Overall median survival estimates: BCR: 17.4 months (m), MFS:86.4m and OS:111m. 26 patients developed...