Pathology Data-Based Risk Group Stratification Is Equivalent to That Obtained by Oncotype DX Testing in Prostatic...

Area of Science:

• Urology
• Oncology
• Molecular Diagnostics

Background:

• Prostate carcinoma risk stratification is crucial for prognosis and treatment.
• Gene expression studies like Oncotype DX are used to validate risk in low- to intermediate-risk cases.
• Accurate risk assessment guides therapeutic decision-making.

Purpose of the Study:

• To evaluate the necessity of molecular testing by assessing its correlation with pathology-based risk stratification and PSA levels.
• To determine if molecular testing offers superior risk stratification compared to standard clinicopathologic data.

Main Methods:

• Retrospective analysis of prostate biopsy cases undergoing Oncotype DX testing.
• Comparison of molecular testing results with risk stratification from pathology reports (Gleason score, Grade Group, positive cores) and serum PSA.
• Classification of cases as concordant or discordant based on National Comprehensive Cancer Network risk and therapy recommendations.
• Follow-up data collection for discordant cases to assess the superiority of molecular testing.

Main Results:

• 131 prostate carcinoma cases underwent Oncotype DX testing out of 4967 screened biopsies.
• Risk stratification concordance between molecular testing and clinicopathologic data was 84% (93/111 cases).
• All discordant cases (16%) showed follow-up courses consistent with pathology and PSA-derived risk.

Conclusions:

• Pathology report information and serum PSA levels provide risk stratification equivalent to Oncotype DX testing.
• Routine biopsy assessment combined with PSA levels is sufficient for risk stratification in prostate cancer.
• Molecular testing may not be necessary for risk validation when standard data is available.