Improved Prediction Of Prostate Cancer Recurrence Through Systems Pathology

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health;  Clinical Trials / Drug Trials
Article Date: 15 Jul 2007 - 0:00 PDT

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UroToday.com- Dr. Cordon-Cardo and collaborators report development of systems pathology that incorporates clinical and pathologic variables to predict prostate cancer (CaP) recurrence. Their work appears in the online version of the Journal of Clinical Investigation.

Systems pathology is a methodology that uses object-oriented image analysis, pattern recognition, and quantitative biomarker multiplexing that are analyzed by supervised machine learning algorithms. An initial study based upon 323 patients identified that high levels of androgen receptor as identified by immunohistochemical staining were correlated with a reduced time to PSA recurrence. This was then combined with the pathologic variables of biopsy Gleason score, seminal vesicle invasion, extracapsular extension, primary radical prostatectomy Gleason score, and preoperative PSA in addition to the texture of epithelial nuclei and cytoplasm in tumor areas for the systems pathology platform.

A validation study was performed in 366 patients but only 61 of these had adequate tissue in the microarrays to be included. PSA recurrence was found in 26 of the 61 men (43%). The model applied to these 61 patients demonstrated a sensitivity of 96% and a specificity of 72% for the detection of PSA recurrence by 5 years post surgery.

The authors comment that this approach provides an aspect of personalized medicine to help decision-making.

Cordon-Cardo C, Kotsianti A, Verbel DA, Teverovskiy M, Capodieci P, Hamann S, Jeffers Y, Clayton M, Elkhettabi F, Khan FM, Sapir M, Bayer-Zubek V, Vengrenyuk Y, Fogarsi S, Saidi O, Reuter VE, Scher HI, Kattan MW, jr. Bianco FJ, Wheeler TM, Ayala GE, Scardino PT, Donovan MJ

J Clin Invest. ePub, June 7, 2007
Doi: 10.1172/JCI31399

Reported by UroToday.com Contributing Editor Christopher P. Evans, M.D

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