Abstract
Background: Intraductal carcinoma and cribriform (IDC/C) tumor features are well-established
prognosticators of biochemical recurrence (BCR), metastasis, and prostate cancer (PCa)-specific
mortality. However, approximately 70% of PCa patients undergoing a radical prostatectomy
are IDC/C negative, yet up-to 20% of these patients progress and experience BCR. Thus,
tumor histopathologic characteristics such as IDC/C alone are limited in their ability
to predict disease progression. Conversely, several nomograms such as Cancer of the
Prostate Risk Assessment-Surgery (CAPRA-S) have been developed to aid in the prognostication
of BCR, but not yet widely applied in clinical settings. Materials and methods: In this study, we assessed the combined prognostic utility of IDC/C, and CAPRA-S
for BCR in 3 PCa patient cohorts. Results: CAPRA-S+IDC/C improved the predictive accuracy of BCR in all 3 cohorts (P < .001). Specifically, among IDC/C negative cases, CAPRA-S improved the prognostication
of BCR in low-risk (Cohort 1; P < .001, Cohort 2; P < .001, Cohort 3; P = .003), intermediate (Cohort 1; P < .001, Cohort 2; P = .006, Cohort 3; P = .03) and high-risk (Cohort 1-3; P < .001) patients. Conversely, IDC/C improved the prognostication of BCR among CAPRA-S
low-risk (Cohorts 1; P < .001 and Cohort 3; P = .003) patients. Conclusion: Our results suggest the investigation of histopathological IDC/C features in CAPRA-S
low-risk patients and conversely, nomogram CAPRA-S among IDC/C negative patients improves
the identification of patients likely to experience BCR, which would otherwise be
missed through current assessment regimens. These patients can be offered more intensive
monitoring and adjuvant therapies upfront to circumvent the development of recurrent
cancer or overtreatment at the time of surgery.
Keywords
Abbreviations:
IDC/C (PCa), CAPRA-S (BCR), GS (GP), GG (PSA)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: January 14, 2022
Accepted:
January 4,
2022
Received in revised form:
January 3,
2022
Received:
August 16,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
