External validation of the CAPRA-S score to predict biochemical recurrence, metastasis and mortality after radical prostatectomy in a European cohort.

Abstract

PURPOSE:

The CAPRA-S score predicts prostate cancer recurrence based on pathological information from radical prostatectomy. To our knowledge CAPRA-S has never been externally validated in a European cohort. We independently validated CAPRA-S in a single institution European database.

MATERIALS AND METHODS:

The study cohort comprised 14,532 patients treated with radical prostatectomy between January 1992 and August 2012. Prediction of biochemical recurrence, metastasis and cancer specific mortality by CAPRA-S was assessed by Kaplan-Meier analysis and the c-index. CAPRA-S performance to predict biochemical recurrence was evaluated by calibration plot and decision curve analysis.

RESULTS:

Median followup was 50.8 months (IQR 25.0-96.0). Biochemical recurrence developed in 20.3% of men at a median of 21.2 months (IQR 7.7-44.9). When stratifying patients by CAPRA-S risk group, estimated 5-year biochemical recurrence-free survival was 91.4%, 70.4% and 29.3% in the low, intermediate and high risk groups, respectively. The CAPRA-S c-index to predict biochemical recurrence, metastasis and cancer specific mortality was 0.80, 0.85 and 0.88, respectively. Metastasis developed in 417 men and 196 men died of prostate cancer.

CONCLUSIONS:

The CAPRA-S score was accurate when applied in a European study cohort. It predicted biochemical recurrence, metastasis and cancer specific mortality after radical prostatectomy with a c-index of greater than 0.80. The score can be valuable in regard to decision making for adjuvant therapy.

• Authors: Derya Tilki, Philipp Mandel, Thorsten Schlomm, Felix K-H Chun, Pierre Tennstedt, Dirk Pehrke, Alexander Haese, Hartwig Huland, Markus Graefen, Georg Salomon
• Journal: The Journal of urology (J Urol) Vol. 193 Issue 6 Pg. 1970-5 (Jun 2015) ISSN: 1527-3792 [Electronic] United States
• PMID: 25498570 (Publication Type: Journal Article, Validation Study)
• Copyright: Copyright © 2015. Published by Elsevier Inc.

Chemical References

• Prostate-Specific Antigen

Topics

• Europe
• Humans
• Male
• Middle Aged
• Neoplasm Metastasis
• Neoplasm Recurrence, Local (blood, epidemiology)
• Prognosis
• Prospective Studies
• Prostate-Specific Antigen (blood)
• Prostatectomy
• Prostatic Neoplasms (blood, mortality, pathology, surgery)
• Risk