Cell-cycle progression tied to metastasis-free survival in high-risk prostate cancer
17 Nov 2022
Cell-cycle progression, but not phosphatase and tensin homolog, appears to significantly elevate the risk of metastasis in men with prostate cancer following Cancer of the Prostate Risk Assessment Post-Surgical adjustment, suggests a study.
A team of investigators calculated the cell-cycle progression score from RNA expression in a case cohort of 209 prostatectomy patients with intermediate- or high-risk prostate cancer and a cohort of 172 such men who received salvage radiotherapy. They also analysed phosphatase and tensin homolog using immunohistochemistry.
The associations of cell-cycle progression, phosphatase, and tensin homolog with metastasis-free survival were assessed using proportional hazards regression, weighted for case-cohort design or unweighted for the salvage radiotherapy cohort. The investigators also evaluated improvement in model discrimination with the concordance index.
Forty-one men in the case cohort and 17 in the salvage radiotherapy cohort developed metastasis over a median follow-up of 3 and 4 years, respectively.
In both cohorts, cell-cycle progression independently correlated with metastasis-free survival after Cancer of the Prostate Risk Assessment Post-Surgical adjustment (case cohort: hazard ratio [HR], 3.11, 95 percent confidence interval [CI], 1.70‒5.69; salvage radiotherapy cohort: HR, 1.85, 95 percent CI, 1.19‒2.85).
The integration of cell-cycle progression to Cancer of the Prostate Risk Assessment Post-Surgical increased the concordance index from 0.861 to 0.899 in the case cohort and from 0.745 to 0.819 in the salvage radiotherapy cohort.
The associations of phosphatase and tensin homolog with metastasis-free survival was statistically significant in univariate analyses but not after Cancer of the Prostate Risk Assessment Post-Surgical adjustment.
“Analysis of interaction with National Comprehensive Cancer Network risk group showed that cell-cycle progression had the strongest effect among unfavorable intermediate-risk men,” the investigators said.