Prognostic value of a cell cycle progression signature for prostate cancer death in a conservatively managed needle biopsy cohort.
Cuzick, J;
Berney, DM;
Fisher, G;
Mesher, D;
Møller, H;
Reid, JE;
Perry, M;
Park, J;
Younus, A;
Gutin, A;
+5 more...Foster, CS;
Scardino, P;
Lanchbury, JS;
Stone, S;
Transatlantic Prostate Group;
(2012)
Prognostic value of a cell cycle progression signature for prostate cancer death in a conservatively managed needle biopsy cohort.
British journal of cancer, 106 (6).
pp. 1095-1099.
ISSN 0007-0920
DOI: https://doi.org/10.1038/bjc.2012.39
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BACKGROUND: The natural history of prostate cancer is highly variable and it is difficult to predict. We showed previously that a cell cycle progression (CCP) score was a robust predictor of outcome in a conservatively managed cohort diagnosed by transurethral resection of the prostate. A greater need is to predict outcome in patients diagnosed by needle biopsy. METHODS: Total RNA was extracted from paraffin specimens. A CCP score was calculated from expression levels of 31 genes. Clinical variables consisted of centrally re-reviewed Gleason score, baseline prostate-specific antigen level, age, clinical stage, and extent of disease. The primary endpoint was death from prostate cancer. RESULTS: In univariate analysis (n=349), the hazard ratio (HR) for death from prostate cancer was 2.02 (95% CI (1.62, 2.53), P<10(-9)) for a one-unit increase in CCP score. The CCP score was only weakly correlated with standard prognostic factors and in a multivariate analysis, CCP score dominated (HR for one-unit increase=1.65, 95% CI (1.31, 2.09), P=3 × 10(-5)), with Gleason score (P=5 × 10(-4)) and prostate-specific antigen (PSA) (P=0.017) providing significant additional contributions. CONCLUSION: For conservatively managed patients, the CCP score is the strongest independent predictor of cancer death outcome yet described and may prove valuable in managing clinically localised prostate cancer.