In this study, the authors externally validate the CCR score using their retrospective institutional data of 767 men with localized prostate adenocarcinoma who were treated between 2006 and 2011; median clinical follow−up time of 5.6 years measured from date of diagnosis.
Of these men, 217 men had CCR scores ≤ 0.8, thereby meeting criteria for low-risk disease and AS candidacy. However, it should be noted that in this institution, during that time period, AS was the not the treatment modality of choice – hence, 125 were treated by radical prostatectomy, 61 with radiation, 2 with radiation with hormones, 2 with hormones only, and 19 with watchful waiting. Treatment for eight men was unknown.
Of these men, only one patient (0.5%) with a CCR score below the 0.8 AS threshold progressed to metastatic disease; he had been initially treated with radiation. As such, due to lack of RP pathology, it is possible he had higher risk disease missed on biopsy.
7-year MFS, BCR-free survival, and cancer-specific mortality is significantly lower in men with CCR score < 0.8, even within AUA low, intermediate and high risk populations. There no deaths in men with CCR < 0.8.
However, based on these findings, the authors state that the AS cutoff for the CCR score helps identify men with low risk of metastatic spread. It should be noted, though, that as many of these men were treated, this is a hard conclusion to make – treatment naturally modifies their expected clinical course.
Speaker: Daniel Canter
Co-authors: Julia E. Reid, Maria Latsis, Margaret Variano, Shams Halat, Kristen E. Gurtner, Michael K. Brawer, Steven Stone, Stephen Bardot
Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, Twitter: @tchandra_uromd at the 2018 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, February 8-10, 2018 - San Francisco, CA
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