The Within-Group Discrimination Ability of the Cancer of the Prostate Risk Assessment Score for Men with Intermediate-Risk Prostate Cancer
- Author:
Ho Won KANG
1
;
Hae Do JUNG
;
Joo Yong LEE
;
Jong Kyou KWON
;
Seong Uk JEH
;
Kang Su CHO
;
Won Sik HAM
;
Young Deuk CHOI
Author Information
- Publication Type:Original Article
- Keywords: Prostate-specific Antigen; Prostate-specific Antigen Density; Prostatic Neoplasms; Prostatectomy; Biochemical Recurrence
- MeSH: Counseling; Discrimination (Psychology); Follow-Up Studies; Goats; Humans; Male; Neoplasm Grading; Pathology; Pathology, Surgical; Population Characteristics; Prostate; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms; Recurrence; Retrospective Studies; Risk Assessment; ROC Curve
- From:Journal of Korean Medical Science 2018;33(5):e36-
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Significant clinical heterogeneity within contemporary risk group is well known, particularly for those with intermediate-risk prostate cancer (IRPCa). Our study aimed to analyze the ability of the Cancer of the Prostate Risk Assessment (CAPRA) score to discern between favorable and non-favorable risk in patients with IRPCa. METHODS: We retrospectively reviewed the data of 203 IRPCa patients who underwent extraperitoneal robot-assisted radical prostatectomy (RARP) performed by a single surgeon. Pathologic favorable IRPCa was defined as a Gleason score ≤ 6 and organ-confined stage at surgical pathology. The CAPRA score was compared with two established criteria for the within-group discrimination ability. RESULTS: Overall, 38 patients (18.7% of the IRPCa cohort) had favorable pathologic features after RARP. The CAPRA score significantly correlated with established criteria I and II and was inversely associated with favorable pathology (all P < 0.001). The area under the receiver operating characteristic curve for the discriminative ability between favorable and non-favorable pathology was 0.679 for the CAPRA score and 0.610 and 0.661 for established criteria I and II, respectively. During a median 37.8 (interquartile range, 24.6–60.2) months of follow-up, 66 patients (32.5%) experienced biochemical recurrence (BCR). Cox regression analysis revealed that the CAPRA score, as a continuous sum score model or 3-group risk model, was an independent predictor of BCR after RARP. CONCLUSION: The within-group discrimination ability of preoperative CAPRA score might help in patient counseling and selecting optimal treatments for those with IRPCa.
