Histologically Overt Stromal Response and the Risk of Progression after Radical Prostatectomy for Prostate Cancer
Authors:
- Mutlay SayanMSMutlay Sayan
- Yetkin TuacYetkin Tuac
- Samet KucukcolakSKSamet Kucukcolak
- Mary D. RowanMRMary D. Rowan
- Grace K. PrattGPGrace K. Pratt
- Cagdas AktanCACagdas Aktan
- Elza TjioETElza Tjio
- Dilara AkbulutDADilara Akbulut
- Shalini MoningiSMShalini Moningi
- Jonathan E. LeemanJLJonathan E. Leeman
- Peter F. OrioPOPeter F. Orio
- Paul L. NguyenPNPaul L. Nguyen
Open Access
Abstract
Purpose: Given the variable clinical course of prostate cancer and the limitations of current prognostic factors, this study was conducted to investigate the impact of a histologically overt stromal response (HOST-response) to prostate cancer on clinical outcomes after radical prostatectomy. Methods: This retrospective analysis utilized The Cancer Genome Atlas (TCGA) to evaluate data from individuals with a confirmed diagnosis of prostate cancer who underwent radical prostatectomy and had available pathology slides. These slides were assessed for the presence of a HOST-response, similar to desmoplasia. The primary endpoint was progression-free survival (PFS). A multivariable competing risk regression analysis was used to assess whether a significant association existed between HOST-response and PFS, adjusting for known prostate cancer prognostic factors. Results: Among the 348 patients analyzed, 166 (47.70%) demonstrated a HOST-response. After a median follow-up of 37.87 months (IQR: 21.20, 65.50), the presence of a HOST-response was significantly associated with a shorter PFS (SDHR, 2.10; 95% CI, 1.26 to 3.50; p = 0.004), after adjusting for covariates. Conclusions: HOST-response in prostate cancer patients treated with radical prostatectomy is significantly associated with reduced PFS, suggesting a potential benefit from adjuvant therapy and highlighting the need for further investigation in a prospective randomized clinical trial.Keywords
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