Journal article
External validation of genomic classifier-based risk-stratification tool to identify candidates for adjuvant radiation therapy in patients with prostate cancer
World journal of urology, Vol.39(9), pp.3217-3222
09/01/2021
DOI: 10.1007/s00345-020-03540-1
PMID: 33388922
Abstract
Objective To externally validate a Genomic Classifier (GC) based risk-stratification nomogram identifying candidates who would benefit from adjuvant radiation (aRT) therapy after radical prostatectomy (RP). Methods We identified 350 patients who underwent RP, between 2013 and 2018, and had adverse pathological features (positive margin, and/or pT3a or higher) on final pathology. Genomic profile was available for all these men. The clinical recurrence-free survival was estimated using the Kaplan-Meier method. The external validity of the nomogram was tested using the concordance index (c-index), calibration plot, and decision curve analysis. Results The median follow-up of the cohort was 26.5 months. Overall, 14% of the patients received aRT. During the follow-up period, 3.4% of the patients developed metastasis. Overall 3-year metastasis-free survival was 95% (95% CI 0.92-0.98). The c-index of the nomogram was 0.84. The calibration of the model was favorable. Decision-curve analysis showed a positive net benefit for probabilities ranging between 0.01 and 0.09, with the highest difference at threshold probability around 0.05. At that threshold, the net benefit is 0.06 for the model and 0 for treating all the patients. Conclusion Our report is the first to confirm the validity of this genomic-based risk-stratification tool in identifying men who might benefit from aRT after RP. As such, it can be a useful instrument to be incorporated in shared decision making on whether administration of aRT will lead to a clinically meaningful benefit. Such a model can also be useful for patients' classification in future clinical trials.
Details
- Title: Subtitle
- External validation of genomic classifier-based risk-stratification tool to identify candidates for adjuvant radiation therapy in patients with prostate cancer
- Creators
- David I. Lee - University of PennsylvaniaMohammed Shahait - King Hussein Cancer CenterDeepansh Dalela - University of PennsylvaniaJacob Keeley - University of PennsylvaniaPriti Lal - University of PennsylvaniaNeha Vapiwala - Wayne State UniversityFiras Abdollah - Henry Ford Hospital
- Resource Type
- Journal article
- Publication Details
- World journal of urology, Vol.39(9), pp.3217-3222
- DOI
- 10.1007/s00345-020-03540-1
- PMID
- 33388922
- NLM abbreviation
- World J Urol
- ISSN
- 0724-4983
- eISSN
- 1433-8726
- Publisher
- Springer Nature
- Number of pages
- 6
- Language
- English
- Date published
- 09/01/2021
- Academic Unit
- Urology
- Record Identifier
- 9984949193302771
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