Clinical Details: This area describes clinical details associated with your prostate cancer. This information is gathered from your pathology report and is NOT used to generate your Decipher result.
PSA (ng/mL): Prostate-specific antigen (PSA) is made by the prostate gland and found in the blood. High PSA levels may indicate infection, benign prostate hyperplasia (BPH) or cancer in the prostate gland.
NCCN Risk Category: NCCN (National Comprehensive Cancer Network) Guidelines recommends that a man’s prostate cancer be classified into one of five risk categories – very low, low, intermediate, high, or very high risk. The PSA level and density, the results from a needle biopsy and the stage of the prostate cancer are taken into consideration.
Biopsy Gleason Score: Two Gleason Grade numbers are added together to produce the Gleason score. A biopsy Gleason score once could range from 2 to 10, but with advances in staining technology, more commonly ranges between 6 and 10. The first Gleason Grade number indicates the Gleason Grade of the cancer cells found most commonly within the sample, the second number represents the second most commonly found grade. Higher Gleason scores are associated with increased cancer aggressiveness.
Specimen Type: A core needle biopsy is the main method used to diagnose prostate cancer.
# of Positive Cores: The number of biopsy cores that contain cancer.
Clinical Stage: The clinical stage is the best estimate of the extent of the disease, based on the results of the physical exam, lab tests, prostate biopsy, and any imaging tests.
Results:
This section describes the overall risk results of your Decipher test. Generally, the lower the Decipher Score (0 being lowest risk to 1 being highest risk), the lower the risk of high grade disease, metastatic spread, and prostate cancer specific mortality. This score, as well as your risk percent likelihood (described below), may help your health care provider determine if active surveillance may be appropriate, or if treatment intensification may be needed for a definitive therapy such as surgery or radiation therapy and/or hormone deprivation therapy to reduce the risk of metastases.
High Grade Disease –High grade cancer cells (with Primary Gleason 4 or 5 on surgical pathology) tend to grow and spread more quickly than low-grade cancer cells. High grade cancers often have worse prognosis than low-grade cancers and may need treatment right away or treatment that is more aggressive. In this example 12.3% likelihood means that if the patient underwent a radical prostatectomy, there would be a 12.3% risk or likelihood that the patient may receive a primary Gleason grade of 4 or 5 upon surgical pathology review. The higher the percentage, the greater the risk.
5-Year Metastasis – This represents your overall risk of having prostate cancer that may spread to other areas, most commonly bone. In this example 1% likelihood means that, if the patient underwent a radical prostatectomy, there would be a 1% chance the patient may develop metastasis within 5 years. The higher the percentage, the greater the risk.
10-Year Prostate Cancer Specific Mortality – This represents your overall risk of prostate cancer specific death after 10 years based on the genomic characteristics of your prostate cancer. In this example 1.9% likelihood means that, if the patient underwent a radical prostatectomy, there would be a 1.9% chance the patient may die from prostate cancer at 10 years. The higher the percentage, the greater the risk.
This section is a visual representation for the overall result of the risk classification based on the genomic evaluation of the tumor that was found in your prostate biopsy specimen.
Test Description:
This section describes how the Decipher test works. Essentially, a panel of molecular biomarkers specific to prostate cancer progression and metastasis, represented by multiple biological pathways, are examined from the tumor tissue to determine your individual Decipher Score.
Intended Use: This section describes how the Decipher Test was intended to be used as a decision making tool between a patient and their health care provider, and the type of patient who would benefit most from the test.
Confidence Intervals: For a 95% confidence interval, it means that if the same population is sampled many times the test results would fall within the confidence intervals 95% of the time.
