THE "NEW" PROSTATE CANCER INFOLINK

The Cancer of the Prostate Risk Assessment or CAPRA scoring system was developed by a group at the University of California at San Francisco (UCSF) as a tool that uses clinical variables to generate a prostate cancer risk-stratification score ranging from 0 to 10. AT UCSF, the CAPRA score is used most commonly to help to determine and monitor patients who may be most suitable for active surveillance. However, the CAPRA score can also be used to predict the progression-free survival (PFS) of patients who decide to have surgery.

Loeb et al. have now published the results of an external validation of the CAPRA score as a tool to predict the PFS at 5 years in a single-surgeon series of 990 patient undergoing radical retropubic prostatectomy (RRP) between 2003 and 2009.

They showed that:

• CAPRA scores were significantly associated with the risk of early biochemical progression.
• 5-year PFS was markedly different for patients with the lowest (0 or 1) and the highest (7 to 10) CAPRA scores — 95 vs. 40 percent, respectively.
• The apparent accuracy of the CAPRA score for the prediction of biochemical progression in these patients was actually higher than the accuracy in the original patient series used to evaluate the accuracy of the CAPRA score.

The authors conclude that:

• The CAPRA score was a significant predictor of 5-year PFS in this single-surgeon series.
• The CAPRA score is a simple preoperative tool that can help risk-stratify prostate cancer patients.

We seem to be getting closer to the point at which any newly patient would be wise to ask his doctor to assess his CAPRA score and apply that as one of the tools that would help in the selection of appropriate therapy — particularly for those patients trying to decide whether active surveillance or immediate treatment was an appropriate option for management of localized disease.

Filed under: Diagnosis, Management, Risk, Treatment Tagged: | CAPRA score, prognosis, risk, startification