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Matthew R. Cooperberg - One of the best experts on this subject based on the ideXlab platform.

  • The Capra Score at 10 Years: Contemporary Perspectives and Analysis of Supporting Studies.
    European urology, 2016
    Co-Authors: Jonathan S. Brajtbord, Michael Leapman, Matthew R. Cooperberg
    Abstract:

    Abstract Tools that appraise oncologic risk are a critical component of research and clinical management of prostate cancer (PCa). We performed a PubMed/Medline search to review the concept, design, and clinical validation of the Cancer of the Prostate Risk Assessment (Capra) score and similar systems in the postsurgical (Capra-S) and primary androgen deprivation therapy (Japan Capra [J-Capra]) settings. We included reports addressing the Capra ( n =13), Capra-S ( n =4), and J-Capra ( n =5) scores. External validation studies for the Capra score have yielded favorable clinical performance in both academic and community cohorts, with concordance index (c-index) for biochemical recurrence (BCR) after definitive treatment in the range of 0.66–0.81. Validation studies addressing the postsurgical Capra-S score have demonstrated favorable prediction of distant end points (c-index for BCR: 0.73–0.80; prostate cancer–specific mortality [PCSM]: 0.75–0.88). The J-Capra score was evaluated in 1378 men treated with primary ADT and demonstrated excellent discrimination (c-index for progression-free survival: 0.80–0.89; PCSM: 0.820–0.836; overall survival: 0.665–0.700). The Capra score and its derivatives have demonstrated robust clinical discrimination in a decade of validation studies. The Capra score and similar multivariable stratification systems are posed to replace prior older and less accurate risk group categories. Patient summary We addressed the development of the Cancer of the Prostate Risk Assessment (Capra) score, its methodology, and its supporting studies. The Capra score and similarly designed tools have yielded strong performance in the prediction of numerous prostate cancer end points.

  • combined value of validated clinical and genomic risk stratification tools for predicting prostate cancer mortality in a high risk prostatectomy cohort
    European Urology, 2015
    Co-Authors: Matthew R. Cooperberg, Elai Davicioni, Anamaria Crisan, Robert B Jenkins, Mercedeh Ghadessi, Jeffrey R Karnes
    Abstract:

    Background: Risk prediction models that incorporate biomarkers and clinicopathologic variables may be used to improve decision making after radical prostatectomy (RP). We compared two previously validated post-RP classifiers—the Cancer of the Prostate Risk Assessment Postsurgical (Capra-S) and the Decipher genomic classifier (GC)—to predict prostate cancer–specific mortality (CSM) in a contemporary cohort of RP patients. Objective: To evaluate the combined prognostic ability of Capra-S and GC to predict CSM. Design, setting, and participants: A cohort of 1010 patients at high risk of recurrence after RP were treated at the Mayo Clinic between 2000 and 2006. High risk was defined by any of the following: preoperative prostate-specific antigen >20 ng/ml, pathologic Gleason score � 8, or stage pT3b. A case-cohort random sample identified 225 patients (with cases defined as patients who experienced CSM), among whom Capra-S and GC could be determined for 185 patients. Outcome measurements and statistical analysis: The scores were evaluated individually and in combination using concordance index (c-index), decision curve analysis, reclassification, cumulative incidence, and Cox regression for the prediction of CSM. Results and limitations: Among 185 men, 28 experienced CSM. The c-indices for Capra-S and GC were 0.75 (95% confidence interval [CI], 0.55–0.84) and 0.78 (95% CI, 0.68–0.87), respectively. GC showed higher net benefit on decision curve analysis, but a score combining Capra-S and GC did not improve the area under the receiveroperating characteristic curve after optimism-adjusted bootstrapping. In 82 patients stratified to high risk based on Capra-S score � 6, GC scores were likewise high risk for 33 patients, among whom 17 had CSM events. GC reclassified the remaining 49 men as low to intermediate risk; among these men, three CSM events were observed. In multivariable analysis, GC and Capra-S as continuous variables were independently prognostic of CSM, with hazard ratios (HRs) of 1.81 ( p < 0.001 per 0.1-unit change in score) and 1.36 ( p = 0.01 per 1-unit change in score). When categorized into risk groups, the multivariable HR for high Capra-S scores (� 6) was 2.36 ( p = 0.04) and was 11.26 ( p < 0.001) for high GC scores (� 0.6). For patients with both high GC and high Capra-S scores, the cumulative incidence of CSM was 45% at 10 yr. The study is limited by its retrospective design.

  • Multi-institutional validation of the Capra-S score to predict disease recurrence and mortality after radical prostatectomy.
    European urology, 2013
    Co-Authors: Sanoj Punnen, Stephen J Freedland, Joseph C Presti, Christopher L Amling, Martha K Terris, William J Aronson, Peter R Carroll, Christopher J. Kane, Matthew R. Cooperberg
    Abstract:

    Abstract Background The University of California, San Francisco, Cancer of the Prostate Risk Assessment Postsurgical (Capra-S) score uses pathologic data from radical prostatectomy (RP) to predict prostate cancer recurrence and mortality. However, this clinical tool has never been validated externally. Objective To validate Capra-S in a large, multi-institutional, external database. Design, setting, and participants The Shared Equal Access Regional Cancer Hospital (SEARCH) database consists of 2892 men who underwent RP from 2001 to 2011. With a median follow-up of 58 mo, 2670 men (92%) had complete data to calculate a Capra-S score. Intervention RP. Outcome measurements and statistical analysis The main outcome was biochemical recurrence. Performance of Capra-S in detecting recurrence was assessed and compared with a validated postoperative nomogram by concordance index (c-index), calibration plots, and decision curve analysis. Prediction of cancer-specific mortality was assessed by Kaplan-Meier analysis and the c-index. Results and limitations The mean age was 62 yr (standard deviation: 6.3), and 34.3% of men had recurrence. The 5-yr progression-free probability for those patients with a Capra-S score of 0–2, 3–5, and 6–10 (defining low, intermediate, and high risk) was 72%, 39%, and 17%, respectively. The Capra-S c-index was 0.73 in this validation set, compared with a c-index of 0.72 for the Stephenson nomogram. Although Capra-S was optimistic in predicting the likelihood of being free of recurrence at 5 yr, it outperformed the Stephenson nomogram on both calibration plots and decision curve analysis. The c-index for predicting cancer-specific mortality was 0.85, with the caveat that this number is based on only 61 events. Conclusions In this external validation, the Capra-S score predicted recurrence and mortality after RP with a c-index >0.70. The score is an effective prognostic tool that may aid in determining the need for adjuvant therapy.

  • the Capra s score a straightforward tool for improved prediction of outcomes after radical prostatectomy
    Cancer, 2011
    Co-Authors: Matthew R. Cooperberg, Joan F Hilton, Peter R Carroll
    Abstract:

    BACKGROUND: The authors previously developed and validated the Cancer of the Prostate Risk Assessment (Capra) score to predict prostate cancer recurrence based on pretreatment clinical data. They aimed to develop a similar postsurgical score with improved accuracy via incorporation of pathologic data. METHODS: A total of 3837 prostatectomy patients in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE™) national disease registry were analyzed. Cox regression was used to determine the predictive power of preoperative prostate-specific antigen (PSA), pathologic Gleason score (pGS), surgical margins (SM), extracapsular extension (ECE), seminal vesicle invasion (SVI), and lymph node invasion (LNI). Points were assigned based on the relative weights of these variables in predicting recurrence. The new postsurgical score (Capra-S) was tested and compared with a commonly cited nomogram with proportional hazards analysis, concordance (c) index, calibration plots, and decision-curve analysis. RESULTS: Recurrence appeared in 16.8% of the men; actuarial progression-free probability at 5 years was 78.0%. The Capra-S was determined by adding up to 3 points for PSA, up to 3 points for pGS, 1 point each for ECE and LNI, and 2 points each for SM and SVI. The hazard ratio for each point increase in Capra-S score was 1.54 (95% confidence interval, 1.49-1.59), indicating a 2.4-fold increase in risk for each 2-point increase in score. The Capra-S c-index was 0.77, substantially higher than 0.66 for the pretreatment Capra score and comparable to 0.76 for the nomogram. The Capra-S score performed better in both calibration and decision curve analyses. CONCLUSIONS: The Capra-S offers good discriminatory accuracy, calibration, and ease of calculation for clinical and research settings. Cancer 2011;. © 2011 American Cancer Society.

  • risk assessment for prostate cancer metastasis and mortality at the time of diagnosis
    Journal of the National Cancer Institute, 2009
    Co-Authors: Matthew R. Cooperberg, Jeanette M Broering, Peter R Carroll
    Abstract:

    Background Although many tools for the assessment of prostate cancer risk have been published, most are designed to predict only biochemical recurrence, usually after a single specified treatment. We assessed the accuracy of the Cancer of the Prostate Risk Assessment (Capra) score, which was validated previously to predict pathological and biochemical outcomes after radical prostatectomy, to predict metastases, prostate cancer – specific mortality, and all-cause mortality. Methods We studied 10 627 men with clinically localized prostate cancer in the Cancer of the Prostate Strategic Urologic Research Endeavor registry, who underwent primary radical prostatectomy, radiation therapy (external beam or interstitial), androgen deprivation monotherapy, or watchful waiting/active surveillance, and had at least 6 months of follow-up after treatment. Capra scores were calculated at diagnosis from the prostate-specific antigen level, Gleason score, percentage of biopsy cores that were positive for cancer, clinical tumor stage, and age at diagnosis. Survival was studied with Kaplan – Meier analyses. Associations between increasing Capra scores and bone metastasis, cancer-specific mortality, and allcause mortality were examined by use of proportional hazards regression, with adjustment for primary treatment; for all-cause mortality, the analysis also included adjustment for age and comorbidity. Accuracy of the Capra score was assessed with the concordance ( c )-index. Results Among the 10 627 patients, 311 (2.9%) men developed bone metastases, 251 (2.4%) died of prostate cancer, and 1582 (14.9%) died of other causes. Each single-point increase in the Capra score was associated with increased bone metastases (hazard ratio [HR] for bone metastases = 1.47, 95% confidence interval [CI] = 1.39 to 1.56), cancer-specific mortality (HR for prostate cancer death = 1.39, 95% CI = 1.31 to 1.48), and all-cause mortality (HR for death = 1.13, 95% CI = 1.10 to 1.16). The Capra score was accurate for predicting metastases ( c -index = 0.78), cancer-specific mortality ( c -index = 0.80), and all-cause mortality ( c -index = 0.71). Conclusions In a large cohort of patients with clinically localized prostate cancer who were managed with one of five primary modalities, the Capra score predicted clinical prostate cancer endpoints with good accuracy. These results support the value of the Capra score as a risk assessment and stratification tool for both research studies and clinical practice. J Natl Cancer Inst 2009;101: 878 – 887

Yongshuai Peng - One of the best experts on this subject based on the ideXlab platform.

  • duplex taqman real time pcr assay for simultaneous detection and quantification of anaplasma Capra and anaplasma phagocytophilum infection
    Molecular and Cellular Probes, 2020
    Co-Authors: Shanshan Zhao, Haiyan Wang, Jinxing Song, Liwei Zhang, Jun Wang, Changshen Ning, Yongshuai Peng
    Abstract:

    Abstract Anaplasma Capra and A. phagocytophilum, two species of the family Anaplasmataceae, are zoonotic tick-borne obligate intracellular bacteria affecting wild and domestic ruminants, dogs, cats, horses and humans. A. Capra and A. phagocytophilum infections have been steadily increasing in both number and geographic distribution, and the accurate diagnosis of these infections is challenging. This study aimed to develop a rapid, sensitive and reliable duplex real-time PCR assay for the specific detection and differentiation of these Anaplasma species. We designed primers and probes against the conserved regions of A. Capra groEL and A. phagocytophilum 16S rRNA genes. A range of PCR-related parameters were evaluated such as the dosage of primers and probes, and annealing temperature. The specificity, sensitivity and repeatability of this assay were evaluated. Assay performance was further evaluated using samples collected from 124 goats in four regions of Henan, China. This set of samples was also tested using conventional PCR under conditions previously described. The developed duplex real-time PCR assay allowed the simultaneous detection of A. Capra and A. phagocytophilum in a reasonably short time at levels as small as 102 copies/μL, respectively, with optimal specificity and reproducibility. In addition, this duplex real-time PCR assay is the first DNA-based method designed to detect A. Capra and A. phagocytophilum, and will be valuable for timely diagnosis and treatment of these infections.

  • Dogs as New Hosts for the Emerging Zoonotic Pathogen Anaplasma Capra in China.
    Frontiers in cellular and infection microbiology, 2019
    Co-Authors: Ke Shi, Yaqun Yan, Qian Chen, Kunlun Wang, Yongchun Zhou, Yuancai Chen, Yongshuai Peng
    Abstract:

    Anaplasma Capra is an emerging zoonotic tick-borne pathogen with a broad host range, including many mammals. Dogs have close physical interactions with humans and regular contact with the external environment. Moreover, they have been previously reported to be hosts of Anaplasma phagocytophilum, A. platys, A. ovis, and A. bovis. To confirm whether dogs are also hosts of A. Capra, pathogen DNA was extracted from blood samples of 521 dogs, followed by PCR amplification of the citrate synthase (gltA) gene, heat shock protein (groEL) gene, and major surface protein 4 (msp4) gene of the A. Capra. A total of 12.1% (63/521) of blood samples were shown to be A. Capra-positive by PCR screening. No significant differences were observed between genders (P = 0.578) or types (P = 0.154) of dogs with A. Capra infections. However, significantly higher A. Capra infections occurred in dogs with regular contact with vegetation (P = 0.002), those aged over 10 years (P = 0.040), and during the summer season (P = 0.006). Phylogenetic analysis based on gltA, groEL, and msp4 sequences demonstrated that the isolates obtained in this study were clustered within the A. Capra clade, and were distinct from other Anaplasma species. In conclusion, dogs were shown to be a host of the human pathogenic A. Capra. Considering the affinity between dogs and humans and the zoonotic tick-borne nature of A. Capra, dogs should be carefully monitored for the presence of A. Capra.

  • Detection and Phylogenetic Characterization of Anaplasma Capra: An Emerging Pathogen in Sheep and Goats in China
    Frontiers Media S.A., 2018
    Co-Authors: Yaqun Yan, Kunlun Wang, Yongshuai Peng, Shanshan Zhao, Haiyan Wang, Jichun Jing
    Abstract:

    Anaplasma Capra is an emerging pathogen, which can infect ruminants and humans. This study was conducted to determine the occurrence of A. Capra in the blood samples of sheep and goats in China. Using nested polymerase chain reaction (nested-PCR) targeting the gltA gene and conventional PCR targeting the heat shock protein (groEL) gene and the major surface protein4 gene (msp4), A. Capra was detected in 129 (8.9%) of 1453 sheep and goat blood samples. The positive rate was higher in goats (9.4%, 89/943) than in sheep (7.8%, 40/510) (χ2 = 1.04, p > 0.05, df = 1). For sheep, A. Capra was found in 17 sites from 2 provinces. The prevalence was 28.6% in sheep from Liaoning province, which was higher than in Henan Province (7.3%). For goats, A. Capra was detected in 35 sites from 7 provinces. The prevalence varied from 0 to 19.4% in the goat sites examined. The prevalence rates were 19.4, 19.3, 10, 8.8, 6.8, 1.8, and 0% in goats from Guizhou province, Henan Province, Inner Mongolia Autonomous Region, Shanxi Province, Xinjiang Uygur Autonomous Region, Yunnan province, and Gansu province, respectively. Based on the analysis of the A. Capra citrate synthase gene (gltA), two variants were identified. Variant I showed a high sequence similarity to the A. Capra, which were previously reported in sheep, goats, Ixodes persulcatus, Haemaphysalis longicornis, Haemaphysalis qinghaiensis, and humans. Variant II was only found in Luoyang, Anyang, and Sanmengxia, of Henan province. To our knowledge, this is the first detection of this variant of A. Capra in sheep and goat blood in China. Phylogenetic analysis based on groEL and msp4 genes showed that the Anaplasma sp. sequences clustered independently from A. Capra and other Anaplasma species with high bootstrap values. We found A. Capra DNA in sheep and goats in China, providing evidence that sheep and goats can be infected by A. Capra. We also found that this zoonotic pathogen is widely distributed in China. This study provides information for assessing the public health risks for human anaplasmosis

Pierre Taberlet - One of the best experts on this subject based on the ideXlab platform.

  • evolutionary history of the genus Capra mammalia artiodactyla discordance between mitochondrial dna and y chromosome phylogenies
    Molecular Phylogenetics and Evolution, 2006
    Co-Authors: N. Pidancier, Gordon Luikart, S. Jordan, Pierre Taberlet
    Abstract:

    The systematics of the genus Capra remain controversial in spite of studies conducted using morphology, mtDNA, and allozymes. Here, we assess the evolutionary history of Capra (i) using phylogenetic analysis of two nuclear genes located on the Y-chromosome and (ii) previously published and new cytochrome b sequences. For the Y-chromosome phylogeny, we sequenced segments from the amelogenin (AMELY) and zinc finger (ZFY) genes from all of the eight wild taxa and from domestic goats (Capra hircus). Phylogenetic analysis of the Y-chromosome data revealed two well-defined clades. The domestic goat (C. hircus), the bezoar (Capra aegagrus), and the markhor (C. falconeri) belong to one clade (ML bootstrap value [BP]: 98%), suggesting that domestic goats originated from one or both of these wild species. The second clade (ML BP: 92%) is comprised of all the other wild species. Horn morphology is generally concordant with the Y-chromosome phylogeny. The mtDNA data also revealed two well-defined clades. However, the species in each clade are different from those inferred from the Y-chromosome data. To explain the discordance between Y-chromosome and mtDNA phylogenies, several hypotheses are considered. We suggest that a plausible scenario involves mtDNA introgression between ancestral taxa before the relatively recent colonization of Western Europe, the Caucasus Mountains, and East Africa by Capra populations.

  • Evolutionary history of the genus Capra (Mammalia, Artiodactyla): Discordance between mitochondrial DNA and Y-chromosome phylogenies
    Molecular Phylogenetics and Evolution, 2006
    Co-Authors: N. Pidancier, Gordon Luikart, S. Jordan, Pierre Taberlet
    Abstract:

    The systematics of the genus Capra remain controversial in spite of studies conducted using morphology, mtDNA, and allozymes. Here, we assess the evolutionary history of Capra (i) using phylogenetic analysis of two nuclear genes located on the Y-chromosome and (ii) previously published and new cytochrome b sequences. For the Y-chromosome phylogeny, we sequenced segments from the amelogenin (AMELY) and zinc finger (ZFY) genes from all of the eight wild taxa and from domestic goats (Capra hircus). Phylogenetic analysis of the Y-chromosome data revealed two well-defined clades. The domestic goat (C. hircus), the bezoar (Capra aegagrus), and the markhor (C. falconeri) belong to one clade (ML bootstrap value [BP]: 98%), suggesting that domestic goats originated from one or both of these wild species. The second clade (ML BP: 92%) is comprised of all the other wild species. Horn morphology is generally concordant with the Y-chromosome phylogeny. The mtDNA data also revealed two well-defined clades. However, the species in each clade are different from those inferred from the Y-chromosome data. To explain the discordance between Y-chromosome and mtDNA phylogenies, several hypotheses are considered. We suggest that a plausible scenario involves mtDNA introgression between ancestral taxa before the relatively recent colonization of Western Europe, the Caucasus Mountains, and East Africa by Capra populations. (c) 2006 Elsevier Inc. All rights reserved.

  • Development of microsatellite multiplexes for wild goats using primers designed from domestic Bovidae
    Genetics Selection Evolution, 2001
    Co-Authors: C. Maudet, Gordon Luikart, Pierre Taberlet
    Abstract:

    Many wild goat taxa (Capra spp.) are endangered and would benefit from the availability of molecular tools that are useful for population management and conservation. We developed microsatellite DNA markers useful in all wild goat species, by using a cross-species amplification approach. Seventy-five microsatellite primer pairs designed from domestic cattle (Bos taurus), sheep (Ovis aries) and goat (Capra hircus) were tested on three distantly related Capra species: C. ibex ibex, C. [i.] sibirica, and C. pyrenaica. On average, 90% of the domestic ungulate primers amplified a microsatellite PCR product in the wild goat species. Forty percent of the total were polymorphic in C. i. ibex, which is expected to have the lowest genetic diversity among all Capra species. We developed multiplexes of 24 polymorphic fluorescent microsatellite loci that can be amplified in 13 PCR reactions and loaded into two gel-lanes. These microsatellites will allow studies of conservation and population ecology in all Capra species, and the multiplexes will reduce the time and cost of the genetic analyses.

  • Development of microsatellite multiplexes for wild goats using primers designed from domestic Bovidae
    Genetics Selection Evolution, 2001
    Co-Authors: C. Maudet, Gordon Luikart, Pierre Taberlet
    Abstract:

    Many wild goat taxa (Capra spp.) are endangered and would benefit from the availability of molecular tools that are useful for population management and conservation. We developed microsatellite DNA markers useful in all wild goat species, by using a cross-species amplification approach. Seventy-five microsatellite primer pairs designed from domestic cattle (Bos taurus), sheep (Ovis aries) and goat (Capra hircus) were tested oil three distantly related Capra species: C. ibex ibex, C. [i.] sibirica, and C. pyrenaica. On average, 90% of the domestic ungulate primers amplified a microsatellite PCR product in the wild goat species. Forty percent of the total were polymorphic in C. i. ibex, which is expected to have the lowest genetic diversity among all Capra species. We developed multiplexes of 24 polymorphic fluorescent microsatellite loci that can be amplified in 13 PCR reactions and loaded into two gel-lanes. Those microsatellites will allow studies of conservation and population ecology in all Capra species, and the multiplexes will reduce the time and cost of the genetic analyses.

Ralf Hoffmann - One of the best experts on this subject based on the ideXlab platform.

  • the association of the long prostate cancer expressed pde4d transcripts to poor patient outcome depends on the tumour s tmprss2 erg fusion status
    Prostate Cancer, 2019
    Co-Authors: Dianne Van Strijp, George S Baillie, Christiane De Witz, Birthe Heitkotter, Sebastian Huss, Martin Bogemann, Axel Semjonow, Miles D Houslay, Chris H Bangma, Ralf Hoffmann
    Abstract:

    Objectives. To investigate the added value of assessing transcripts for the long cAMP phosphodiesterase-4D (PDE4D) isoforms, PDE4D5 and PDE4D9, regarding the prognostic power of the ‘Capra & PDE4D7’ combination risk model to predict longitudinal postsurgical biological outcomes in prostate cancer. Patients and Methods. RNA was extracted from both biopsy punches of resected tumours (606 patients; RP cohort) and diagnostic needle biopsies (168 patients; DB cohort). RT-qPCR was performed in order to determine PDE4D5, PDE4D7, and PDE4D9 transcript scores in both study cohorts. By RNA sequencing, we determined the TMPRSS2-ERG fusion status of each tumour sample in the RP cohort. Kaplan-Meier survival analyses were then applied to correlate the PDE4D5, PDE4D7 and PDE4D9 scores with postsurgical patient outcomes. Logistic regression was then used to combine the clinical Capra score with PDE4D5, PDE4D7, and PDE4D9 scores in order to build a ‘Capra & PDE4D5/7/9’ regression model. ROC and decision curve analysis was used to estimate the net benefit of the ‘Capra & PDE4D5/7/9’ risk model. Results. Kaplan-Meier survival analysis, on the RP cohort, revealed a significant association of the PDE4D7 score with postsurgical biochemical recurrence (BCR) in the presence of the TMPRSS2-ERG gene rearrangement (logrank p<0.0001), compared to the absence of this gene fusion event (logrank p=0.08). In contrast, the PDE4D5 score was only significantly associated with BCR in TMPRSS2-ERG fusion negative tumours (logrank p<0.0001 vs. logrank p=0.4 for TMPRSS2-ERG+ tumours). This was similar for the PDE4D9 score although less pronounced compared to that of the PDE4D5 score (TMPRSS2ERG- logrank p<0.0001 vs. TMPRSS2ERG+ logrank p<0.005). In order to predict BCR after primary treatment, we undertook ROC analysis of the logistic regression combination model of the Capra score with the PDE4D5, PDE4D7, and PDE4D9 scores. For the DB cohort, this demonstrated significant differences in the AUC between the Capra and the PDE4D5/7/9 regression model vs. the Capra and PDE4D7 risk model (AUC 0.87 vs. 0.82; p=0.049) vs. the Capra score alone (AUC 0.87 vs. 0.77; p=0.005). The Capra and PDE4D5/7/9 risk model stratified 19.2% patients of the DB cohort to either ‘no risk of biochemical relapse’ (NPV 100%) or the ‘start of any secondary treatment (NPV 100%)’, over a follow-up period of up to 15 years. Decision curve analysis presented a clear, net benefit for the use of the novel Capra & PDE4D5/7/9 risk model compared to the clinical Capra score alone or the Capra and PDE4D7 model across all decision thresholds. Conclusion. Association of the long PDE4D5, PDE4D7, and PDE4D9 transcript scores to prostate cancer patient outcome, after primary intervention, varies in opposite directions depending on the TMPRSS2-ERG genomic fusion background of the tumour. Adding transcript scores for the long PDE4D isoforms, PDE4D5 and PDE4D9, to our previously presented combination risk model of the combined ‘Capra & PDE4D7’ score, in order to generate the Capra and PDE4D5/7/9 score, significantly improves the prognostic power of the model in predicting postsurgical biological outcomes in prostate cancer patients.

Yang Dong - One of the best experts on this subject based on the ideXlab platform.