Correlation between histologic features and Decipher genomic risk in prostate cancer biopsies

Area of Science:

• Oncology
• Genomics
• Pathology

Background:

• The Decipher genomic classifier aids prostate cancer risk stratification.
• Its added value over biopsy pathology is not fully understood.

Purpose of the Study:

• To assess the correlation between Decipher genomic scores and clinicopathologic features in prostate biopsies.
• To determine if histology can predict genomic risk.

Main Methods:

• Retrospective review of 40 prostate biopsies with Decipher testing.
• Analysis of clinical and pathological variables, including ISUP Grade Group and Gleason pattern 4.
• Classification of biopsies into favorable and unfavorable histology groups.

Main Results:

• 32.5% of cases were high genomic risk; 20% had unfavorable histology.
• High genomic risk correlated with higher Grade Groups, increased Gleason pattern 4, and cribriform morphology.
• Unfavorable histology had high specificity but limited sensitivity for identifying high genomic risk.

Conclusions:

• Adverse histologic features partially predict high genomic risk in prostate cancer.
• Genomic testing identifies high-risk tumors not detected by morphology alone.
• Genomic testing offers value beyond traditional pathology for risk stratification.