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Improving the Post-Operative Prediction of BCR-Free Survival Time with mRNA Variables and Machine Learning. Cancers (Basel) 2023; 15:cancers15041276. [PMID: 36831619 PMCID: PMC9954694 DOI: 10.3390/cancers15041276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
Predicting the risk of, and time to biochemical recurrence (BCR) in prostate cancer patients post-operatively is critical in patient treatment decision pathways following surgical intervention. This study aimed to investigate the predictive potential of mRNA information to improve upon reference nomograms and clinical-only models, using a dataset of 187 patients that includes over 20,000 features. Several machine learning methodologies were implemented for the analysis of censored patient follow-up information with such high-dimensional genomic data. Our findings demonstrated the potential of inclusion of mRNA information for BCR-free survival prediction. A random survival forest pipeline was found to achieve high predictive performance with respect to discrimination, calibration, and net benefit. Two mRNA variables, namely ESM1 and DHAH8, were identified as consistently strong predictors with this dataset.
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Gupta K, Mehrotra V, Fu P, Scarberry K, MacLennan GT, Gupta S. Racial disparities in biochemical recurrence of prostate cancer. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2022; 10:266-270. [PMID: 36051618 PMCID: PMC9428572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The aim of this study was to determine the biochemical recurrence among Black and White American men with grade group 2-5 prostate cancer managed primarily by radical prostatectomy (RP). METHODS This was a single-institution, retrospective study evaluating biochemical recurrence by self-identified race. 163 patients who underwent RP at the University Hospitals Cleveland Medical Center between 2015-2021 were analyzed for racial differences in age at diagnosis, clinical stage, and preoperative serum prostate-specific antigen (PSA). Patients were followed for PSA recurrence (PSA ≥ 0.2 ng/ml). Multivariate analysis was used to determine clinical and pathologic variables that were significant in predicting biochemical recurrence after RP and to determine whether race was an independent predictor of biochemical recurrence-free survival (BCRFS). RESULTS Of 163 patients, 82 (50.3%) were Black Americans and 81 (49.7%) were White Americans with a median age of 62.7 ranging between 38.7 to 76.3 years. The grade-specific distribution of cancer 3+4 was 54.9% versus 65.4%; 4+3 was 25.6% versus 30.9%; 4+4 was 7.3% versus 2.5%; 4+5 was 12.2% versus 1.2% in Black American and White American men. Univariate analysis of BCRFS using Kaplan-Meier method demonstrated a significant difference among levels of Gleason score between Black Americans and White Americans (P = 0.041). Multivariable analysis after controlling the effects of age, Gleason score exhibited no significant difference of BCRFS comparing Black and White American men (P = 0.145). Specifically, the hazard of biochemical recurrence among Black Americans was 1.6 times (95% CI: 0.85-3.02) compared to White Americans (P = 0.145). CONCLUSION Our study demonstrated a significant difference in BCRFS between Black and White American patients. Additional studies with larger sample size underlying this clinical disparity are warranted.
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Affiliation(s)
- Karishma Gupta
- Urology Institute, University Hospitals Cleveland Medical CenterCleveland, Ohio 44106, USA
- Department of Urology, Case Western Reserve University School of MedicineCleveland, Ohio 44106, USA
| | - Vidushri Mehrotra
- College of Arts and Sciences, Case Western Reserve UniversityCleveland, Ohio 44106, USA
| | - Pingfu Fu
- Department of Population and Quantitative Health Sciences, Case Western Reserve UniversityCleveland, Ohio 44106, USA
| | - Kyle Scarberry
- Urology Institute, University Hospitals Cleveland Medical CenterCleveland, Ohio 44106, USA
- Department of Urology, Case Western Reserve University School of MedicineCleveland, Ohio 44106, USA
| | - Gregory T MacLennan
- Department of Pathology, Case Western Reserve University School of MedicineCleveland, Ohio 44106, USA
| | - Sanjay Gupta
- Urology Institute, University Hospitals Cleveland Medical CenterCleveland, Ohio 44106, USA
- Department of Urology, Case Western Reserve University School of MedicineCleveland, Ohio 44106, USA
- Department of Pathology, Case Western Reserve University School of MedicineCleveland, Ohio 44106, USA
- Department of Pharmacology, Case Western Reserve UniversityCleveland, Ohio 44106, USA
- Department of Nutrition, Case Western Reserve UniversityCleveland, Ohio 44106, USA
- Division of General Medical Sciences, Case Comprehensive Cancer CenterCleveland, Ohio 44106, USA
- Department of Urology, Louis Stokes Cleveland Veterans Affairs Medical CenterCleveland, Ohio 44106, USA
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Pavel AG, Stambouli D, Gener I, Preda A, Anton G, Baston C. Genetic variant located on chromosome 17p12 contributes to prostate cancer onset and biochemical recurrence. Sci Rep 2022; 12:4546. [PMID: 35296725 PMCID: PMC8927158 DOI: 10.1038/s41598-022-08472-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/07/2022] [Indexed: 12/24/2022] Open
Abstract
The genetic contribution to prostate cancer (PC) onset and clinical heterogeneity has an important impact on the disease stratification accuracy. Despite the fact that radical prostatectomy (RP) is an effective treatment for localized PC, a considerable number of individuals develop biochemical recurrence (BCR) following surgery. In the present study, we decided to investigate the significance of genetic variability in a homogeneous group of Romanian men and to determine if genotyping could provide information regarding the possible implications of rs4054823 susceptibility loci in PC progression and outcome. A total of 78 samples from both PC and benign prostatic hyperplasia (BPH) patients were genotyped. The genotype frequencies were examined to see if there was a link between the 17p12 SNP and PC disease. When compared to the BPH group, the PC group had a significantly higher frequency of the T risk variant (P = 0.0056) and TT genotype (P = 0.0164). Subsequent analysis revealed that the TT genotype had a significantly higher frequency among younger PC patients based on their age at diagnosis and that it was related with a greater probability of BCR (P = 0.02). According to our findings, the TT genotype appears to be a risk factor for early-onset PC and a potential predictor for BCR after RP.
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Affiliation(s)
- Anca Gabriela Pavel
- Molecular Genetics Department, Cytogenomic Medical Laboratory, Bucharest, Romania. .,The Romania Academy, "Stefan S. Nicolau" Institute of Virology, Bucharest, Romania.
| | - Danae Stambouli
- Molecular Genetics Department, Cytogenomic Medical Laboratory, Bucharest, Romania
| | - Ismail Gener
- Department of Nephrology, Urology, Immunology and Immunology of Transplant, Dermatology, Allergology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania
| | - Adrian Preda
- Center of Urological Surgery, Dialysis and Renal Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Gabriela Anton
- The Romania Academy, "Stefan S. Nicolau" Institute of Virology, Bucharest, Romania
| | - Catalin Baston
- Department of Nephrology, Urology, Immunology and Immunology of Transplant, Dermatology, Allergology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Center of Urological Surgery, Dialysis and Renal Transplantation, Fundeni Clinical Institute, Bucharest, Romania
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Rosas S, Hughes RT, Farris M, Lee H, McTyre ER, Plate JF, Shi L, Emory CL, Blackstock AW, Kerr BA, Willey JS. Cartilage oligomeric matrix protein in patients with osteoarthritis is independently associated with metastatic disease in prostate cancer. Oncotarget 2019; 10:4776-4785. [PMID: 31413818 PMCID: PMC6677668 DOI: 10.18632/oncotarget.27113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/29/2019] [Indexed: 11/25/2022] Open
Abstract
Metastatic prostate cancer has a 5-year survival rate of 30%. Identifying predictors of metastasis outcome could potentially reduce patient mortality. The objective of this study was to determine whether osteoarthritis had an impact on outcomes of prostate cancer including death, local recurrence and/or metastasis and to determine whether cartilage oligomeric matrix protein was involved. We performed a retrospective case-control study of patients with prostate cancer with and without the diagnosis of osteoarthritis and completed immunohistochemistry (IHC) analysis of prostate (n=20) and lymph node (n=7) surgical specimens. We evaluated death, local recurrence and metastatic disease by various IHC biomarkers including prostate specific membrane antigen (PSMA), cartilage oligomeric matrix protein (COMP), CD31, and Ki-67. Our model identified osteoarthritis as an independent risk factor for metastatic disease (OR 5.24, 95% CI 1.49 - 18.41). Most notably, when joint arthroplasty was included in the model, osteoarthritis was no longer an independent risk factor for this outcome (p=0.071). IHC demonstrated that those with osteoarthritis, had greater expression of COMP in the prostate samples (mean 23.9% vs 5.84%, p<0.05) but not of Ki-67, CD31, or PSMA. This study identified and quantified increased metastatic disease in patients with osteoarthritis. Also, patients with osteoarthritis expressed increased COMP levels in the prostate and most likely in distant lymphatic nodes. Moreover, our findings suggest that joint arthroplasty may affect the ability of osteoarthritis to promote metastasis, which could impact treatment protocols and survival outcomes of the most common cause of cancer-related death (metastasis) in the United States.
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Affiliation(s)
- Samuel Rosas
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ryan T. Hughes
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Michael Farris
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hwajin Lee
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Emory R. McTyre
- Radiation Oncology, Greenville Health System Cancer Institute, Greenville, SC, USA
| | - Johannes F. Plate
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lihong Shi
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Cynthia L. Emory
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - A. William Blackstock
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Bethany A. Kerr
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jeffrey S. Willey
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
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