Margolis Eric, Lowentritt Benjamin H, Pieczonka Christopher M, Bennett John P, Pavlova Marina, Zambon Joao Paulo, Groskopf Jack, Uchio Edward
Hackensack Meridian School of Medicine Nutley NJ USA.
Chesapeake Urology Towson MD USA.
BJUI Compass. 2025 Mar 17;6(3):e494. doi: 10.1002/bco2.494. eCollection 2025 Mar.
To assess the factors associated with the use of active surveillance (AS) in NCCN favourable intermediate-risk (FIR) prostate cancer (PCa) patients who received the 17-gene Genomic Prostate Score (GPS) assay.
Contemporary data were collected from academic and large community group practices across the United States. Eligible patients had localized PCa classified as FIR per NCCN guidelines and received a GPS report between May 2017 and April 2019. Higher GPS results (scale: 0-100) were associated with a higher risk of adverse outcomes. The proportion of patients selecting AS was calculated with 95% confidence intervals. Uni-and multivariable logistic regression analyses were performed to determine the association between AS selection and relevant covariates.
There were 324 eligible patients (Gleason Score 3 + 4, 79%; PSA 10-20 ng/ml, 19%; clinical stage T2b-T2c, 2%; median percent positive cores, 16.7%; median GPS result, 26). The distribution of GPS results was 0-19 (23%), 20-40 (60%), and 41-100 (16%). Overall, 31% (95% CI 26%, 36%) selected AS: 58% (46%, 69%) with GPS 0-19, 27% (21%, 33%) with GPS 20-40, and 6% (1%, 16%) with GPS 41-100. In univariable models, the Gleason score, percent positive cores, PSA, and GPS results were significantly associated with AS selection. In a multivariable model, the percent positive cores and the GPS result remained significantly associated with AS selection. AS persistence was 91% (82%, 95%) at 12 months.
The GPS result and percent positive cores appear associated with AS use after controlling for relevant clinical variables in NCCN FIR prostate cancer patients.
评估在接受17基因基因组前列腺评分（GPS）检测的美国国立综合癌症网络（NCCN）低危中危（FIR）前列腺癌（PCa）患者中，与主动监测（AS）使用相关的因素。
收集了来自美国各地学术机构和大型社区团体诊所的当代数据。符合条件的患者患有根据NCCN指南分类为FIR的局限性PCa，并在2017年5月至2019年4月期间收到了GPS报告。较高的GPS结果（范围：0-100）与不良结局风险较高相关。计算选择AS的患者比例及其95%置信区间。进行单变量和多变量逻辑回归分析，以确定AS选择与相关协变量之间的关联。
共有324例符合条件的患者（ Gleason评分3 + 4，79%；前列腺特异性抗原[PSA] 10-20 ng/ml，19%；临床分期T2b-T2c，2%；阳性核心百分比中位数，16.7%；GPS结果中位数，26）。GPS结果分布为0-19（23%）、20-40（60%）和41-100（16%）。总体而言，31%（95% CI 26%，36%）选择了AS：GPS为0-19的患者中58%（46%，69%）选择了AS，GPS为20-40的患者中27%（21%，33%）选择了AS，GPS为41-100的患者中6%（1%，16%）选择了AS。在单变量模型中，Gleason评分、阳性核心百分比、PSA和GPS结果与AS选择显著相关。在多变量模型中，阳性核心百分比和GPS结果与AS选择仍显著相关。12个月时AS持续率为91%（82%，95%）。
在控制NCCN FIR前列腺癌患者的相关临床变量后，GPS结果和阳性核心百分比似乎与AS的使用相关。
