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Decipher Score predicts prostate specific antigen persistence after prostatectomy.

Patrick-Julien Treacy1,2,3, Ugo G Falagario4,5, François Magniez4

  • 1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA - pj.treacy@live.fr.

Minerva Urology and Nephrology
|September 20, 2023
PubMed
Summary
This summary is machine-generated.

Persistent prostate-specific antigen (PSA) after surgery indicates a worse prognosis. This study identified unique genomic features and confirmed Decipher Score as a predictor, suggesting further imaging for early treatment intensification in high-risk patients.

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Area of Science:

  • Urology
  • Genomics
  • Oncology

Background:

  • Persistent prostate-specific antigen (PSA) after radical prostatectomy (RP) is associated with poorer outcomes.
  • Evaluating genomic risk in patients with persistent PSA (pPSA) is crucial for prognosis.

Purpose of the Study:

  • To assess the genomic risk of patients with pPSA using mRNA expression and a validated genomic-risk classifier.
  • To identify predictors of pPSA and differential gene expression in a specific patient subpopulation.

Main Methods:

  • Retrospective monocentric study of 564 patients undergoing RP, analyzing pPSA based on consecutive PSA >0.1 ng/mL.
  • Utilized the Decipher Test and performed multivariate analysis for pPSA predictors.
  • Conducted genomic differential expression analyses comparing patients with and without pPSA in a localized, organ-confined, negative margin subpopulation.

Main Results:

  • 61 out of 564 patients had pPSA, with higher preoperative PSA and PSA density in this group.
  • Decipher Score (OR=5.64) and preoperative PSA (OR=1.06) were significant predictors of pPSA on multivariate analysis.
  • Two genes, SERPINB11 and PDE11A, were significantly upregulated (2.5-fold change) in the pPSA subpopulation.

Conclusions:

  • Patients with pPSA exhibit distinct genomic features and a worse prognosis.
  • Genomic profiling, including the Decipher Score, aids in identifying high-risk patients.
  • Further imaging studies are recommended for early treatment selection in patients with pPSA.