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External Validation of the CAPRA-S Score to Predict Biochemical Recurrence, Metastasis and Mortality after Radical Prostatectomy in a European Cohort

2014; Lippincott Williams & Wilkins; Volume: 193; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2014.12.020

1527-3792

Derya Tilki, Philipp Mandel, Thorsten Schlomm, Felix K.‐H. Chun, Pierre Tennstedt, Dirk Pehrke, Alexander Haese, Hartwig Huland, Markus Graefen, Georg Salomon,

Cancer, Lipids, and Metabolism

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.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.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.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.