{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T21:50:24Z","timestamp":1785880224179,"version":"3.56.0"},"reference-count":31,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016939","name":"Myriad Genetics Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016939","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinical-genitourinary-cancer.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Genitourinary Cancer"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.clgc.2026.102586","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T15:55:23Z","timestamp":1779292523000},"page":"102586","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robust Meta-Analysis of a Clinical Cell-Cycle Risk (CCR) Score Demonstrates Broadly Applicable Metastasis and Disease-Specific Mortality Risk Stratification in Men With Localized Prostate Cancer"],"prefix":"10.1016","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1140-0603","authenticated-orcid":false,"given":"Todd M.","family":"Morgan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1957-1068","authenticated-orcid":false,"given":"Lauren H.","family":"Lenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2771-4049","authenticated-orcid":false,"given":"Ivan","family":"Henriquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Monda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Garc\u00eda-Pablo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wyatt","family":"Clegg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Finch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Mabey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Britton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. David","family":"Crawford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Lewicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanoj","family":"Punnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5767-0548","authenticated-orcid":false,"given":"Neal D.","family":"Shore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7614-9931","authenticated-orcid":false,"given":"Jeffrey J.","family":"Tosoian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Jasper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6565-3729","authenticated-orcid":false,"given":"Alexander","family":"Gutin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2325-4228","authenticated-orcid":false,"given":"Matthew J.","family":"Schiewer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7765-4473","authenticated-orcid":false,"given":"Jonathan D.","family":"Tward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"6","key":"10.1016\/j.clgc.2026.102586_bib0001","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1111\/bju.13911","article-title":"Prognostic utility of biopsy-derived cell cycle progression score in patients with National Comprehensive Cancer Network low-risk prostate cancer undergoing radical prostatectomy: implications for treatment guidance","volume":"120","author":"Tosoian","year":"2017","journal-title":"BJU Int"},{"key":"10.1016\/j.clgc.2026.102586_bib0002","article-title":"Clinical utility of gene expression classifiers in men with newly diagnosed prostate cancer","volume":"2","author":"Hu","year":"2018","journal-title":"JCO Precis Oncol"},{"issue":"1","key":"10.1016\/j.clgc.2026.102586_bib0003","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.eururo.2014.11.038","article-title":"Prognostic value of the cell cycle progression score in patients with prostate cancer: a systematic review and meta-analysis","volume":"69","author":"Sommariva","year":"2016","journal-title":"Eur Urol"},{"issue":"8","key":"10.1016\/j.clgc.2026.102586_bib0004","article-title":"Validation of the cell cycle progression score to differentiate indolent from aggressive prostate cancer in men diagnosed through transurethral resection of the prostate biopsy","volume":"5","author":"Cuzick","year":"2022","journal-title":"Cancer Rep (Hoboken)"},{"issue":"4","key":"10.1016\/j.clgc.2026.102586_bib0005","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1002\/pros.24103","article-title":"Cell-cycle risk score more accurately determines the risk for metastases and death in prostatectomy patients compared with clinical features alone","volume":"81","author":"Swanson","year":"2021","journal-title":"Prostate"},{"issue":"11","key":"10.1016\/j.clgc.2026.102586_bib0006","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1200\/JCO.2012.46.4396","article-title":"Validation of a cell-cycle progression gene panel to improve risk stratification in a contemporary prostatectomy cohort","volume":"31","author":"Cooperberg","year":"2013","journal-title":"J Clin Oncol"},{"issue":"3","key":"10.1016\/j.clgc.2026.102586_bib0007","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S1470-2045(10)70295-3","article-title":"Prognostic value of an RNA expression signature derived from cell cycle proliferation genes in patients with prostate cancer: a retrospective study","author":"Cuzick","year":"2011","journal-title":"Lancet Oncol"},{"issue":"1","key":"10.1016\/j.clgc.2026.102586_bib0008","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ijrobp.2021.09.034","article-title":"The clinical cell-cycle risk (CCR) score is associated with metastasis after radiation therapy and provides guidance on when to forgo combined androgen deprivation therapy with dose-escalated radiation","volume":"113","author":"Tward","year":"2022","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"10.1016\/j.clgc.2026.102586_bib0009","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.clgc.2021.01.003","article-title":"Personalizing localized prostate cancer: validation of a combined clinical cell-cycle risk (CCR) score threshold for prognosticating benefit from multimodality therapy","volume":"19","author":"Tward","year":"2021","journal-title":"Clin Genitourin Cancer"},{"issue":"3","key":"10.1016\/j.clgc.2026.102586_bib0010","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.eururo.2018.10.028","article-title":"Comparison of the prognostic utility of the cell cycle progression score for predicting clinical outcomes in African American and Non-African American men with localized prostate cancer","volume":"75","author":"Canter","year":"2019","journal-title":"Eur Urol"},{"issue":"6","key":"10.1016\/j.clgc.2026.102586_bib0011","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.urolonc.2018.03.011","article-title":"Identification of men with low-risk biopsy-confirmed prostate cancer as candidates for active surveillance","volume":"36","author":"Lin","year":"2018","journal-title":"Urol Oncol"},{"issue":"1","key":"10.1016\/j.clgc.2026.102586_bib0012","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1038\/s41391-019-0159-9","article-title":"Analysis of the prognostic utility of the cell cycle progression (CCP) score generated from needle biopsy in men treated with definitive therapy","volume":"23","author":"Canter","year":"2020","journal-title":"Prostate Cancer Prostatic Dis"},{"issue":"6","key":"10.1016\/j.clgc.2026.102586_bib0013","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1097\/01.ju.0000158155.33890.e7","article-title":"The University Of California, San Francisco Cancer Of The prostate risk assessment score: a straightforward and reliable preoperative predictor Of disease recurrence after radical prostatectomy","volume":"173","author":"Cooperberg","year":"2005","journal-title":"J Urol"},{"issue":"6_suppl","key":"10.1016\/j.clgc.2026.102586_bib0014","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1200\/jco.2013.31.6_suppl.67","article-title":"Development and validation of a mutivariate model combining cell cycle progression score with CAPRA to predict prostate cancer mortality in a conservatively managed cohort","volume":"31","author":"Brawer","year":"2013","journal-title":"J Clin Oncol"},{"issue":"6","key":"10.1016\/j.clgc.2026.102586_bib0015","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.urolonc.2018.03.011","article-title":"Identification of men with low-risk biopsy-confirmed prostate cancer as candidates for active surveillance","volume":"36","author":"Lin","year":"2018","journal-title":"Urol Oncol"},{"issue":"4","key":"10.1016\/j.clgc.2026.102586_bib0016","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.clgc.2021.01.003","article-title":"Personalizing localized prostate cancer: validation of a combined clinical cell-cycle risk (CCR) score threshold for prognosticating benefit from multimodality therapy","volume":"19","author":"Tward","year":"2021","journal-title":"Clin Genitourin Cancer"},{"issue":"1","key":"10.1016\/j.clgc.2026.102586_bib0017","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ijrobp.2021.09.034","article-title":"The clinical cell-cycle risk (CCR) score is associated with metastasis after radiation therapy and provides guidance on when to forgo combined androgen deprivation therapy with dose-escalated radiation","volume":"113","author":"Tward","year":"2022","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"10.1016\/j.clgc.2026.102586_bib0018","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.juro.2014.02.003","article-title":"Prognostic utility of the cell cycle progression score generated from biopsy in men treated with prostatectomy","volume":"192","author":"Bishoff","year":"2014","journal-title":"J Urol"},{"issue":"1","key":"10.1016\/j.clgc.2026.102586_bib0019","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1038\/s41391-019-0159-9","article-title":"Analysis of the prognostic utility of the cell cycle progression (CCP) score generated from needle biopsy in men treated with definitive therapy","volume":"23","author":"Canter","year":"2019","journal-title":"Prostate Cancer Prostatic Dis"},{"issue":"6","key":"10.1016\/j.clgc.2026.102586_bib0020","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1038\/bjc.2012.39","article-title":"Prognostic value of a cell cycle progression signature for prostate cancer death in a conservatively managed needle biopsy cohort","volume":"106","author":"J","year":"2012","journal-title":"Br J Cancer"},{"issue":"3","key":"10.1016\/j.clgc.2026.102586_bib0021","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1038\/bjc.2015.223","article-title":"Validation of an RNA cell cycle progression score for predicting death from prostate cancer in a conservatively managed needle biopsy cohort","volume":"113","author":"Cuzick","year":"2015","journal-title":"Br J Cancer"},{"issue":"8","key":"10.1016\/j.clgc.2026.102586_bib0022","article-title":"Validation of the cell cycle progression score to differentiate indolent from aggressive prostate cancer in men diagnosed through transurethral resection of the prostate biopsy","volume":"5","author":"Cuzick","year":"2021","journal-title":"Cancer Rep (Hoboken)"},{"issue":"8","key":"10.1016\/j.clgc.2026.102586_bib0023","doi-asserted-by":"crossref","DOI":"10.1200\/PO.23.00364","article-title":"Validation of the combined clinical cell-cycle risk score to prognosticate early prostate cancer metastasis from biopsy specimens and comparison with other routinely used risk classifiers","author":"Hutten","year":"2024","journal-title":"JCO Precis Oncol"},{"issue":"6","key":"10.1016\/j.clgc.2026.102586_bib0024","doi-asserted-by":"crossref","first-page":"491","DOI":"10.2217\/pme-2019-0084","article-title":"Clinical outcomes in men with prostate cancer who selected active surveillance using a clinical cell cycle risk score","volume":"16","author":"Kaul","year":"2019","journal-title":"Per Med"},{"issue":"3","key":"10.1016\/j.clgc.2026.102586_bib0025","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.rpor.2017.02.003","article-title":"Prognostic correlation of cell cycle progression score and Ki-67 as a predictor of aggressiveness, biochemical failure, and mortality in men with high-risk prostate cancer treated with external beam radiation therapy","volume":"22","author":"L\u00f3pez","year":"2017","journal-title":"Rep Pract Oncol Radiother"},{"key":"10.1016\/j.clgc.2026.102586_bib0026","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.clgc.2026.102586_bib0027","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.k4597","article-title":"A guide to systematic review and meta-analysis of prognostic factor studies","author":"Riley","year":"2019","journal-title":"BMJ"},{"issue":"feb05 1","key":"10.1016\/j.clgc.2026.102586_bib0028","doi-asserted-by":"crossref","first-page":"c221","DOI":"10.1136\/bmj.c221","article-title":"Meta-analysis of individual participant data: rationale, conduct, and reporting","volume":"340","author":"Riley","year":"2010","journal-title":"BMJ"},{"issue":"6","key":"10.1016\/j.clgc.2026.102586_bib0029","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1038\/bjc.2012.39","article-title":"Prognostic value of a cell cycle progression signature for prostate cancer death in a conservatively managed needle biopsy cohort","volume":"106","author":"Cuzick","year":"2012","journal-title":"Br J Cancer"},{"issue":"3","key":"10.1016\/j.clgc.2026.102586_bib0030","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1038\/bjc.2015.223","article-title":"Validation of an RNA cell cycle progression score for predicting death from prostate cancer in a conservatively managed needle biopsy cohort","volume":"113","author":"Cuzick","year":"2015","journal-title":"Br J Cancer"},{"issue":"2","key":"10.1016\/j.clgc.2026.102586_bib0031","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.eururo.2014.05.039","article-title":"Combined value of validated clinical and genomic risk stratification tools for predicting prostate cancer mortality in a high-risk prostatectomy cohort","volume":"67","author":"Cooperberg","year":"2015","journal-title":"Eur Urol"}],"container-title":["Clinical Genitourinary Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1558767326000868?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1558767326000868?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T21:28:11Z","timestamp":1785878891000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1558767326000868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["S1558767326000868"],"URL":"https:\/\/doi.org\/10.1016\/j.clgc.2026.102586","relation":{},"ISSN":["1558-7673"],"issn-type":[{"value":"1558-7673","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Robust Meta-Analysis of a Clinical Cell-Cycle Risk (CCR) Score Demonstrates Broadly Applicable Metastasis and Disease-Specific Mortality Risk Stratification in Men With Localized Prostate Cancer","name":"articletitle","label":"Article Title"},{"value":"Clinical Genitourinary Cancer","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clgc.2026.102586","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"102586"}}