尽管 Decipher 前列腺癌基因组分类器 (GC) 的预后意义主要是通过对档案组织的分析确定的，但对于在真实情况下接受同时检测和治疗的患者中 Decipher 检测结果与肿瘤结果之间的关联知之甚少。世界实践设置。我们的目的是评估在现实世界中接受测试和治疗的患者中，Decipher GC 与前列腺活检和根治性前列腺切除术 (RP) 后的转移和生化复发 (BCR) 风险之间的关联。来自 Decipher GC 的转录组数据和从保险索赔、药房记录和跨付款人和护理场所的电子健康记录数据汇总的真实临床数据 (RWD) 的新型纵向关联。 Kaplan-Meier 和 Cox 比例风险回归用于检查 GC 与研究结果之间的关联，并调整临床和病理因素。对前列腺癌转移和根治性前列腺切除术后的 BCR、Decipher GC 连续评分和风险类别进行了评估。我们确定了 58,935 名接受 Decipher 测试的参与者，其中 33,379 名接受活检样本，25,556 名接受 RP 样本。活检时的中位年龄为 67 岁（四分位距 [IQR] 62-72），RP 时的中位年龄为 65 岁（IQR 59-69）。活检测试患者的中位 GC 评分为 0.43 (IQR 0.27-0.66)，RP 测试患者的中位 GC 评分为 0.54 (0.32-0.79)。在活检测试（GC 每增加 0.1 单位的风险比 [HR] 1.21 [95% 置信区间 {CI} 1.16-1.27]，p < 0.001）和 RP 测试（HR）中，GC 与转移风险独立相关调整基线临床和病理危险因素后，有 1.20 [95% CI 1.17-1.24]，p < 0.001) 患者。此外，在针对年龄和前列腺癌风险评估术后评分进行调整的模型中，GC 与经过 RP 测试的患者的 BCR 风险相关（HR 1.12 [95% CI 1.10-1.14]，p < 0.001）。 -在全国范围内进行的新型转录组关联的世界研究支持了 Decipher GC 在当代实践中管理的患者中的外部预后有效性。这项研究着眼于 Decipher 基因组分类器的使用，该测试用于帮助了解 Decipher GC 的侵袭性前列腺癌患者。通过查看 58,935 名接受测试的参与者的结果，我们发现 Decipher 测试有助于估计癌症复发和转移的风险。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

Although the prognostic significance of the Decipher prostate cancer genomic classifier (GC) has been established largely from analyses of archival tissue, less is known about the associations between the results of Decipher testing and oncologic outcomes among patients receiving contemporaneous testing and treatment in the real-world practice setting. Our objective was to assess the associations between the Decipher GC and risks of metastasis and biochemical recurrence (BCR) following prostate biopsy and radical prostatectomy (RP) among patients tested and treated in the real-world setting.A retrospective cohort study was conducted using a novel longitudinal linkage of transcriptomic data from the Decipher GC and real-world clinical data (RWD) aggregated from insurance claims, pharmacy records, and electronic health record data across payors and sites of care. Kaplan-Meier and Cox proportional hazards regressions were used to examine the associations between the GC and study outcomes, adjusting for clinical and pathologic factors.Metastasis from prostate cancer and BCR after radical prostatectomy, Decipher GC continuous score, and risk categories were evaluated. We identified 58 935 participants who underwent Decipher testing, including 33 379 on a biopsy specimen and 25 556 on an RP specimen. The median age was 67 yr (interquartile range [IQR] 62-72) at biopsy testing and 65 yr (IQR 59-69) at RP. The median GC score was 0.43 (IQR 0.27-0.66) among biopsy-tested patients and 0.54 (0.32-0.79) among RP-tested patients. The GC was independently associated with the risk of metastasis among biopsy-tested (hazard ratio [HR] per 0.1 unit increase in GC 1.21 [95% confidence interval {CI} 1.16-1.27], p < 0.001) and RP-tested (HR 1.20 [95% CI 1.17-1.24], p < 0.001) patients after adjusting for baseline clinical and pathologic risk factors. In addition, the GC was associated with the risk of BCR among RP-tested patients (HR 1.12 [95% CI 1.10-1.14], p < 0.001) in models adjusted for age and Cancer of the Prostate Risk Assessment postsurgical score.This real-world study of a novel transcriptomic linkage conducted at a national scale supports the external prognostic validity of the Decipher GC among patients managed in contemporary practice.This study looked at the use of the Decipher genomic classifier, a test used to help understand the aggressiveness of a patient's prostate cancer. Looking at the results of 58 935 participants who underwent testing, we found that the Decipher test helped estimate the risk of cancer recurrence and metastasis.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.