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- Title
Histologically Overt Stromal Response and the Risk of Progression after Radical Prostatectomy for Prostate Cancer.
- Authors
Sayan, Mutlay; Tuac, Yetkin; Kucukcolak, Samet; Rowan, Mary D.; Pratt, Grace K.; Aktan, Cagdas; Tjio, Elza; Akbulut, Dilara; Moningi, Shalini; Leeman, Jonathan E.; Orio, Peter F.; Nguyen, Paul L.; D'Amico, Anthony V.; Akgul, Mahmut
- Abstract
Simple Summary: Prostate cancer is a commonly diagnosed cancer in men with varying outcomes following treatment. This study focuses on a specific feature observed in some prostate cancers called a histologically overt stromal response (HOST-response), which involves changes in the tissue surrounding the cancer cells. Our research used data from patients who had undergone surgery for prostate cancer to explore how this stromal response impacted their recovery without the cancer returning. We found that the presence of a HOST-response is linked to a higher chance of the cancer coming back sooner. These findings suggest that monitoring for this feature could help identify patients who might benefit from additional treatments after surgery, which could potentially improve their outcomes. The results of this study could guide future clinical trials aiming to refine treatment strategies for prostate cancer patients exhibiting a HOST-response. 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.
- Subjects
RISK assessment; PEARSON correlation (Statistics); STATISTICAL significance; RADICAL prostatectomy; PROSTATE tumors; RETROSPECTIVE studies; MULTIVARIATE analysis; CHI-squared test; MANN Whitney U Test; DESCRIPTIVE statistics; SURGICAL complications; KAPLAN-Meier estimator; LOG-rank test; STROMAL cells; PROGRESSION-free survival; CONFIDENCE intervals; DATA analysis software; DISEASE progression
- Publication
Cancers, 2024, Vol 16, Issue 10, p1871
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16101871