Oakland University William Beaumont School of Medicine, Bloomfield Hills, MI
Siddharth Ramanathan , Sadhna Ramanathan , Alvaro Martinez , Andrew Korman , Michael Ghilezan , Michael Levin , Zachary Alan Gerndt , Nathan Shen , Kirk Wojno , Howard Korman , Savitha Balaraman
Background: Loeb et al. recently highlighted that academic physicians were statistically more likely to recommend genetic testing to prostate cancer patients per NCCN guidelines compared to physicians at community practices. Several articles have outlined the rate of pathogenic mutations and metastasis free survival (MFS) for prostate cancer patients treated at academic institutions. However, there is a relative paucity of equivalent data regarding patients treated at community urology clinics. We felt it was important to retrospectively review data from our large community based uro-oncology practice and present our findings in an effort to clarify this topic. Methods: We collected data on 562 prostate cancer patients treated at our multidisciplinary uro-oncology clinic between 2016 and 2018. We found 363 patients that satisfied the inclusion criteria of having germline genetic mutation testing and at least 1 year of follow-up. Patients were stratified into three categories based on the results of their germline genetic test: negative for germline mutations, positive for germline pathogenic mutations, or positive for VUS (variant of uncertain significance) mutations. Analysis of variances (ANOVA) was conducted to assess for any differences in age, Gleason score, metastasis rate, and MFS across the groups. A significance level of.05 was used. Results: All patients were treated according to guideline recommendations as was standard for the practice. There was no statistically significant difference in average age or Gleason score between the groups. There was also no statistically significant difference between the MFS across the three groups. Although the metastasis rate and MFS in the group without any mutations (9.8%, 18.3 months) was clinically significant compared to the groups with pathogenic mutations (7.5%, 16.5 months) and VUS mutations (7%, 16.6 months), the differences were not statistically significant (p=.754 and.127 respectively). Conclusions: In our community based uro-oncology practice, we found no statistically significant difference in MFS between patients with pathogenic germline mutations, patients without germline mutations, and patients with VUS mutations at 1 year of follow-up. This does not exclude the possibility of an impact of germline mutations on MFS as the data matures to reach 5 or more years of follow-up.
Mutation status on Germline Testing | Sample Size | Age (years) | Mean Gleason Score | Median Gleason Score | Metastasis Rate (%) | MFS (months) |
---|---|---|---|---|---|---|
Negative | 266 | 67.2 | 7.28 | 3 + 4 = 7 | 9.8 | 18.3 |
Pathogenic Mutation | 40 | 67.3 | 7.39 | 3 + 4 = 7 | 7.5 | 16.5 |
VUS | 57 | 65.9 | 7.34 | 3 + 4 = 7 | 7.01 | 16.6 |
p-value | - | .583 | .705 | - | .754 | .127 |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Samantha Goodenow
2023 ASCO Genitourinary Cancers Symposium
First Author: Joanne Y.H. Lua
2023 ASCO Annual Meeting
First Author: Zachary Klaassen
2018 Genitourinary Cancers Symposium
First Author: Marcus Marie Moses