{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T16:05:18Z","timestamp":1789488318596,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Genomic prostate score (GPS) may aid clinical decision\u2010making for active surveillance. We assessed whether GPS adds predictive value beyond established clinical variables for adverse pathology at radical prostatectomy (RP) in active surveillance\u2010eligible patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 387 men with National Comprehensive Cancer Network very\u2010low\u2010 to favorable intermediate\u2010risk prostate cancer who underwent Oncotype DX testing followed by RP without active surveillance. Multivariable logistic regression models were constructed to develop prediction models for adverse pathology at RP (Grade Group \u2265\u20093 and\/or \u2265\u2009pT3a), including clinical variables (age, PSA, PSA density, biopsy Grade Group 2 [vs. 1], and PI\u2010RADS 4\/5) with and without GPS. Model performance was assessed using the AUC with 10\u2010fold cross\u2010validation and compared using DeLong's test, continuous net reclassification improvement (NRI), and decision curve analysis. The incremental predictive value of GPS was also separately evaluated in very low\/low\u2010risk and favorable intermediate\u2010risk subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      GPS independently predicted adverse pathology (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The addition of GPS increased the AUC from 0.69 to 0.73 (\u0394AUC\u2009=\u20090.036; 95% CI: 0.006\u20130.065;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018) and improved reclassification (NRI 0.41, 95% CI: 0.20\u20130.61). Decision curve analysis demonstrated added net benefit at intermediate threshold probabilities (0.40\u20130.70), with limited benefit at low thresholds (0.0\u20130.40). Improvement was significant in the favorable intermediate\u2010risk subgroup (\u0394AUC\u2009=\u20090.039; 95% CI: 0.011\u20130.124;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026) but not in the very low\/low\u2010risk subgroup (\u0394AUC\u2009=\u20090.018; 95% CI: \u22120.043\u20130.049;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.20). Surgical selection bias was the main limitation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this RP cohort, GPS modestly improved prediction of adverse pathology beyond PSA density and MRI, with clinical utility primarily in favorable intermediate\u2010risk patients, where treatment decisions between active surveillance and definitive therapy are uncertain. These findings suggest selective, risk\u2010adapted application of GPS to guide treatment decision\u2010making. Validation in prospective, diverse cohorts is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70129","type":"journal-article","created":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T15:00:08Z","timestamp":1768748408000},"page":"637-647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Incremental Predictive Value of the Oncotype Genomic Prostate Score for Adverse Pathology in Active Surveillance Candidates"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1633-784X","authenticated-orcid":false,"given":"Yu","family":"Ozawa","sequence":"first","affiliation":[{"name":"AdventHealth Global Robotics Institute Celebration Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio Covas","family":"Moschovas","sequence":"additional","affiliation":[{"name":"AdventHealth Global Robotics Institute Celebration Florida USA"},{"name":"Urology Department University of Central Florida (UCF) Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1422-5695","authenticated-orcid":false,"given":"Marco","family":"Sandri","sequence":"additional","affiliation":[{"name":"Big and Open Data Innovation Laboratory (BODaI\u2010Lab) and Data Methods and Systems Statistical University of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Sharma","sequence":"additional","affiliation":[{"name":"AdventHealth Global Robotics Institute Celebration Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3673-0286","authenticated-orcid":false,"given":"Shady","family":"Saikali","sequence":"additional","affiliation":[{"name":"AdventHealth Global Robotics Institute Celebration Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis","family":"Rogers","sequence":"additional","affiliation":[{"name":"AdventHealth Global Robotics Institute Celebration Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vipul","family":"Patel","sequence":"additional","affiliation":[{"name":"AdventHealth Global Robotics Institute Celebration Florida USA"},{"name":"Urology Department University of Central Florida (UCF) Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.1439"},{"key":"e_1_2_12_3_1","unstructured":"NCCN Guideline: National Comprehensive Cancer Network\u00ae NCCN Guidelines Version 3 Prostate Cancer. 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