Evaluating 4Kscore's role in predicting progression on active surveillance for prostate cancer independently of clinical information and PIRADS score.

Autor: Hougen HY; University of Iowa Hospitals and Clinics, Department of Urology, Iowa City, IA, USA. hhougen@uiowa.edu., Reis IM; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.; Biostatistics and Bioinformatics Shared Resources, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA., Han S; Biostatistics and Bioinformatics Shared Resources, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA., Prakash NS; Desai Sethi Urology Institute, University of Miami, Miami, FL, USA., Thomas J; Desai Sethi Urology Institute, University of Miami, Miami, FL, USA., Stoyanova R; Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA., Castillo RP; Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA., Kryvenko ON; Desai Sethi Urology Institute, University of Miami, Miami, FL, USA.; Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA.; Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA., Ritch CR; Desai Sethi Urology Institute, University of Miami, Miami, FL, USA., Nahar B; Desai Sethi Urology Institute, University of Miami, Miami, FL, USA., Gonzalgo ML; Desai Sethi Urology Institute, University of Miami, Miami, FL, USA., Gaston SM; Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA., Abramowitz MC; Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA., Dal Pra A; Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA., Mahal BA; Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA., Pollack A; Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA., Parekh DJ; Desai Sethi Urology Institute, University of Miami, Miami, FL, USA., Punnen S; Desai Sethi Urology Institute, University of Miami, Miami, FL, USA.
Jazyk: angličtina
Zdroj: Prostate cancer and prostatic diseases [Prostate Cancer Prostatic Dis] 2024 Sep 27. Date of Electronic Publication: 2024 Sep 27.
DOI: 10.1038/s41391-024-00898-w
Abstrakt: Background: 4Kscore is used to aid the decision for prostate biopsy, however its role in active surveillance (AS) has not been investigated in a magnetic resonance imaging (MRI)-based protocol. Our objective was to assess the association between 4Kscore and progression in men undergoing AS on a prospective MRI-based protocol.
Methods: This was a single-institution, single-arm, non-therapeutic, interventional trial of 166 men with biopsy-confirmed prostate cancer enrolled between 2014-2020. Patients were placed on a trial-mandated AS protocol including yearly multiparametric (mp)MRI, prostate biopsy, and 4Kscore followed for 48 months after diagnosis. We analyzed protocol-defined and grade progression at confirmatory and subsequent surveillance biopsies.
Results: Out of 166 patients, 83 (50%) men progressed per protocol and of them 41 (24.7% of whole cohort) progressed by grade. At confirmatory biopsy, men with a baseline 4Kscore ≥ 20% had a higher risk of grade progression compared to those with 4Kscore < 20% (OR = 4.04, 95% CI: 1.05-15.59, p = 0.043) after adjusting for National Comprehensive Cancer Network (NCCN) risk and baseline PIRADS score. At surveillance biopsies, most recent 4Kscore ≥ 20% significantly predicted per protocol (OR = 2.61, 95% CI: 1.03-6.63, p = 0.044) and grade progression (OR = 5.13, 95% CI: 1.63-16.11, p = 0.005).
Conclusions: For patients on AS, baseline 4Kscore predicted grade progression at confirmatory biopsy, and most recent 4Kscore predicted per-protocol and grade progression at surveillance biopsy.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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