Publication: Valor pronóstico de ERG, PTEN, SPINK1, Ki-67, RA y C-MYC en la predicción de recidiva bioquímica tras prostatectomía radical en el cáncer prostático
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2022-10-18
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Universidad Complutense de Madrid
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Abstract
El cáncer prostático (CAP) es de gran prevalencia en el mundo desarrollado, y produce un enorme impacto en morbimortalidad y costes de salud pública. Tras la PR con intención curativa el 25% de los pacientes sufrirán una recidiva bioquímica (RBQ), aunque solo la mitad de ellos tendrán progresión clínica. Poder estadificar a los pacientes correctamente según la extensión tumoral y el riesgo de recidiva o progresión permitiría evitar sobretratamientos con secuelas importantes, indicando más vigilancia activa y evitando tratamientos adyuvantes o de rescate innecesarios. Para ello se utilizan herramientas predictivas como los nomogramas y scores construidos con distintas variables clínico-patológicas, biomarcadores inmunohistoquímicos (IHQ), paneles multigenéticos o pruebas de imagen como la Resonancia magnética multiparamétrica (RMm). Objetivos: Valorar la capacidad pronóstica de RBQ de 7 biomarcadores estudiados mediante IHQ en una población de pacientes con CAP localizado sometidos a Prostatectomía radical (PR). Construir un score predictivo de RBQ basado en CAPRA-S junto a los biomarcadores que pueda mejorar de forma coste-efectiva a otros modelos que incorporan RMm o paneles multigenéticos comercializados (Decipher®). Validar el score en la población y comparar su C-index respecto a CAPRA-S y a otros modelos predictivos...
Prostate cancer (PC) is highly prevalent in the developed world, and has an enormous impact on morbidity and mortality and public health costs. After RP with curative objective, 25% of patients will suffer a biochemical recurrence (BR), although only half of them will have clinical progression. Getting the correctly staging of patients according to the tumor extension and the risk of recurrence or progression would make it possible to avoid overtreatments with significant sequelae, indicating more active surveillance and avoiding unnecessary adjuvant or salvage treatments. For this task we use predictive tools like nomograms and scores constructed with different variables, such as clinicopathological, immunohistochemical biomarkers (IHC), genetic or imaging tests such as multiparametric magnetic resonance imaging (MRI).Objectives: To assess the prognostic capacity of BR of the 7 biomarkers studied by IH in a population of patients with localized PC undergoing RP. To build a predictive score of BR based on CAPRA-S together with the biomarkers that can cost-effectively improve other models or commercial multigenetic panels. Validate the score in the population and compare C-index with respect to CAPRA-S and different predictive models...
Prostate cancer (PC) is highly prevalent in the developed world, and has an enormous impact on morbidity and mortality and public health costs. After RP with curative objective, 25% of patients will suffer a biochemical recurrence (BR), although only half of them will have clinical progression. Getting the correctly staging of patients according to the tumor extension and the risk of recurrence or progression would make it possible to avoid overtreatments with significant sequelae, indicating more active surveillance and avoiding unnecessary adjuvant or salvage treatments. For this task we use predictive tools like nomograms and scores constructed with different variables, such as clinicopathological, immunohistochemical biomarkers (IHC), genetic or imaging tests such as multiparametric magnetic resonance imaging (MRI).Objectives: To assess the prognostic capacity of BR of the 7 biomarkers studied by IH in a population of patients with localized PC undergoing RP. To build a predictive score of BR based on CAPRA-S together with the biomarkers that can cost-effectively improve other models or commercial multigenetic panels. Validate the score in the population and compare C-index with respect to CAPRA-S and different predictive models...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 20-05-2022