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• W4247718053 abstract "e16040 Background: Active surveillance (AS) is an increasingly popular treatment modality for men with localized prostate cancer. However, better risk stratification is needed to appropriately select men for AS. The cell cycle progression (CCP) score has proven to be a robust predictor of prostate cancer outcomes in various clinical settings, including conservatively managed cohorts. Here, we present the validation of an AS threshold for a predefined score (CCR score) that combines the CCP score with CAPRA for predicting prostate cancer mortality (PCM) in conservatively managed patients. Methods: We determined the CCR score distribution in 505 men who were tested in a clinical laboratory and, based on their clinical characteristics, might typically be considered for AS. Specifically, the training cohort consisted of men who had Gleason scores ≤ 3+4; PSA < 10 ng/ml; < 25% cores positive; and clinical stage ≤ T2a. A threshold CCR score of 0.80 was selected such that 90% of the men in the training cohort had scores below the threshold. Threshold performance was then evaluated in two cohorts of conservatively managed men (TAPG1 [N = 180] and TAPG2 [N = 585]). We also evaluated the threshold in a commercially tested cohort (N = 4218). Results: The CCR threshold was validated with the TAPG2 cohort. In this cohort, 10.3% of patients were below the threshold. There were no deaths in patients below the threshold and the Cox proportional hazard estimate of 10−year PCM associated with the CCR threshold was 3.3%. In the combined cohort (TAPG1 and TAPG2), the 10−year risk of PCM associated at the threshold was 3.2% and there were no observed prostate cancer deaths in patients below the threshold. In the commercially tested cohort, 36% of patients qualified for AS on clinical parameters alone. However, when the CCP score was included, 60% of patients had CCR scores below the AS threshold. Conclusions: The threshold presented here was derived from the ‘typical’ risk of PSM for AS patients and can be used to guide patient selection for AS based on an integrated view of risk assessment. Applying the threshold to men recently diagnosed with prostate cancer substantially enlarged the group who might be considered for AS." @default.
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• W4247718053 date "2015-05-20" @default.
• W4247718053 modified "2023-10-09" @default.
• W4247718053 title "Validation of an active surveillance threshold for the CCP score in conservatively managed men with localized prostate cancer." @default.
• W4247718053 doi "https://doi.org/10.1200/jco.2015.33.15_suppl.e16040" @default.
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