title: Cell-cycle Progression-score Might Improve the Current Risk Assessment in Newly Diagnosed Prostate Cancer Patients.
abstract: OBJECTIVE
  To assess whether cell-cycle progression (CCP)-score (Prolaris) can improve the current risk assessment in newly diagnosed prostate cancer (PCa) patients. CCP-score is a well-validated prognostic assay predictive of PCa death, biochemical recurrence, and progression.
  
  
  METHODS
  We evaluated CCP-score at biopsy in 52 patients newly diagnosed with PCa who underwent radical prostatectomy. CCP-score was calculated as average RNA expression of 31 CCP genes, normalized to 15 housekeeping genes. The predictive ability of CCP-score was assessed in univariate and multivariate analyses, and compared to that of Ki-67 levels and traditional clinical variables including prostate-specific antigen, Gleason score, stage, and percentage of positive cores at biopsy.
  
  
  RESULTS
  In spite of an overall good accuracy in attributing the correct risk class, 7 high-risk and 13 intermediate-risk patients were misclassified by the Prolaris test. On analysis of variance, mean CCP-score significantly differed across different risk classes based on pathologic results (-1.2 in low risk, -0.444 in intermediate risk, 0.208 in high risk). CCP-score was a significant predictor of high-risk PCa both on univariate and multivariate analyses, after adjusting for clinical variables. Combining CCP-score and the European Association of Urology clinical risk assessment improved the accuracy of risk attribution by around 10%, up to 87.8%. CCP-score was a significant predictor of biochemical recurrence, but only on univariate analysis.
  
  
  CONCLUSIONS
  The CCP-score might provide important new information to risk assessment of newly diagnosed PCa in addition to traditional clinical variables. A correct risk attribution is essential to tailor the best treatment for each patient.
authors.affiliation: Department of Surgical Sciences, Urology, University of Turin, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Oderda
authors.affiliation: Department of Urology, Istituto Europeo di Oncologia, Milan, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cozzi
authors.affiliation: Deparment of Pathology, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Daniele
authors.affiliation: Deparment of Pathology, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Sapino
authors.affiliation: Department of Surgical Sciences, Urology, University of Turin, Turin, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Munegato
authors.affiliation: Department of Pathology, Istituto Europeo di Oncologia, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Renne
authors.affiliation: Department of Urology, Istituto Europeo di Oncologia, Milan, Italy.
authors.forename: Ottavio
authors.initials: O
authors.lastname: De Cobelli
authors.affiliation: Department of Surgical Sciences, Urology, University of Turin, Turin, Italy. Electronic address: paolo.gontero@unito.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gontero
mesh_terms: D000368:Aged; D002453:Cell Cycle; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment