J Korean Med Sci.  2014 Sep;29(9):1212-1216. 10.3346/jkms.2014.29.9.1212.

Cancer of the Prostate Risk Assessment (CAPRA) Preoperative Score Versus Postoperative Score (CAPRA-S): Ability to Predict Cancer Progression and Decision-Making Regarding Adjuvant Therapy after Radical Prostatectomy

• Seo WI
• Kang PM
• Kang DI
• Yoon JH
• Kim W
• Chung JI

• KMID: 1794598
• DOI: http://doi.org/10.3346/jkms.2014.29.9.1212

Abstract

The University of California, San Francisco, announced in 2011 Cancer of the Prostate Risk Assessment Postsurgical (CAPRA-S) score which included pathologic data, but there were no results for comparing preoperative predictors with the CAPRA-S score. We evaluated the validation of the CAPRA-S score in our institution and compare the result with the preoperative progression predictor, CAPRA score. Data of 130 patients were reviewed who underwent radical prostatectomy for localized prostate cancer from 2008 to 2013. Performance of CAPRA-S score in predicting progression free probabilities was assessed through Kaplan Meier analysis and Cox proportional hazards regression test. Additionally, prediction probability was compared with preoperative CAPRA score by logistic regression analysis. Comparing CAPRA score, the CAPRA-S score showed improved prediction ability for 5 yr progression free survival (concordance index 0.80, P = 0.04). After risk group stratification, 3 group model of CAPRA-S was superior than 3 group model of CAPRA for 3-yr progression free survival and 5-yr progression free survival (concordance index 0.74 vs. 0.70, 0.77 vs. 0.71, P < 0.001). Finally the CAPRA-S score was the more ideal predictor concerned with adjuvant therapy than the CAPRA score through decision curve analysis. The CPARA-S score is a useful predictor for disease progression after radical prostatectomy.

Keyword

Prostatic Neoplasms; Prostatectomy; Disease Progression; Recurrence

MeSH Terms

Combined Modality Therapy
Decision Making
Disease Progression
Disease-Free Survival
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Neoplasm Staging
Postoperative Period
Proportional Hazards Models
Prostate-Specific Antigen/analysis
Prostatectomy
Prostatic Neoplasms/mortality/*pathology/therapy
Retrospective Studies
Prostate-Specific Antigen

Figure

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  Fig. 1 The 5-yr biochemical-progression-free probabilities stratified by CAPRA-S score group (A) and the three-risk-group model (B) using Kaplan-Meier curves.

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  Fig. 2 Decision curve analysis comparing the CAPRA-S and CAPRA scores. The y axis shows the net increase in the proportion of patients appropriately identified for adjuvant treatment. The solid black line represents the strategy involving treating all patients with adjuvant therapy (assuming all will experience recurrence) and the solid gray line represents the strategy involving treating no patients (assuming none will experience recurrence).

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