Prognostic utility of the CCP score generated from biopsy in men treated with prostatectomy.

Journal of Urology (White)

PubMedID: 24508632

Bishoff JT, Freedland SJ, Gerber L, Tennstedt P, Reid J, Welbourn W, Graefen M, Sangale Z, Tikishvili E, Park J, Younus A, Gutin A, Lanchbury JS, Sauter G, Brawer M, Stone S, Schlomm T. Prognostic utility of the CCP score generated from biopsy in men treated with prostatectomy. J Urol. 2014;192(2):409-14.
PURPOSE
The Cell Cycle Progression (CCP) score has been associated with prostate cancer outcome in various clinical settings. However, previous studies of men treated by radical prostatectomy (RP) evaluated CCP scores generated from resected tumor tissue. Here we evaluated the prognostic utility of the score derived from biopsy specimens in men who were treated by radical prostatectomy.

METHODS
We evaluated the CCP score in patient cohorts from the Martini Clinic (MC) (N=283), from the Durham VA Medical Center (DVA) (N=176), and from Intermountain Healthcare (IHC) (N=123). The CCP score was derived from simulated biopsy (MC) or diagnostic biopsy (DVA and IHC) and evaluated for association with biochemical recurrence (BCR) and metastatic disease.

RESULTS
In all three cohorts, the CCP score was associated with BCR and metastatic disease. The association with BCR remained significant after adjusting for other prognostic clinical variables. In a combined analysis of all cohorts (N=582), the CCP score was a strong predictor of BCR in both univariable (HR/unit score=1.60 (95%CI: 1.35, 1.90; p-value=2.4x10(-7))) and multivariable analyses (HR/unit score=1.47 (95%CI: 1.23, 1.76; p-value=4.7x10(-5))). Although there were few events (N=12), CCP score was the strongest predictor of metastatic disease in both univariable analysis (HR/unit score=5.35 (95%CI: 2.89, 9.92; p-value=2.1x10(-8))), and after adjusting for clinical variables (HR/unit score=4.19 (95%CI: 2.08, 8.45; p-value=8.2x10(-6))).

CONCLUSION
CCP score derived from a biopsy sample was associated with adverse outcome after surgery. These results indicate that the CCP score can be used at disease diagnosis to better define patient prognosis and enable more appropriate clinical care.