Data included patient age, PSA, biopsy Gleason score, clinical T-stage and percent of prostate biopsy cores positive. It is a simple to use predictive tool that does not require computer calculations. It has accuracy ranging from 0.66 to 0.81. In Cancer, Dr. Matthew Cooperberg and colleagues developed a post-radical prostatectomy analog of CAPRA incorporating pathologic Gleason score, surgical margin status (SM), extracapsular extension status, seminal vesicle invasion (SVI), and lymph node invasion (LNI).
The CaPSURE national prostate cancer (CaP) registry was used as the database for the study. Exclusion criteria included missing pathologic Gleason score and/or preoperative PSA data. They call the post-surgery CAPRA score CAPRA-S. The scoring structure is a 0 to 10 scale with 3 binary indicators for preoperative PSA and pathologic Gleason score (low, medium, and high levels) and SM, ECE, SVI, and LNI all scored as dichotomous. The final CAPRA-S score was then categorized into 3 groups based upon risk of CaP recurrence - low (score 0-2), intermediate (3-5), and high (6 or greater).
A total of 3,837 men were included in the analysis. PSA recurrence was found in 478 men and need for secondary treatment in 166 men (16.8% total). At 3 and 5 years, a total of 1,843 and 795 men were at risk for recurrence, respectively. The mean hazard ratio for CAPRA-S as a continuous variable was 1.54, thus a 2-point increase in score represented a 2.4-fold increase in risk. The corrected c-index for the CAPRA-S was 0.77 and resulted in greater net benefit across the range of risk thresholds compared with the nomogram predictions. There was less fit at higher CAPRA-S scores, in part due to fewer patients with those characteristics. A total of 40 men died of CaP at a median of 7.6 years and the sub-hazard ratio for cancer-specific mortality for a single point increase in CAPRA-S score was 1.42.
Cooperberg MR, Hilton JF, Carroll PR
Cancer. 2011 Jun 3. Epub ahead of print.
10.1002/cncr.26169
PubMed Abstract
PMID: 21647869
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