Cooperberg Matthew R, Freedland Stephen J, Pasta David J, Elkin Eric P, Presti Joseph C, Amling Christopher L, Terris Martha K, Aronson William J, Kane Christopher J, Carroll Peter R
Department of Urology, Program in Urologic Oncology, Urologic Outcomes Research Group, UCSF Comprehensive Cancer Center, University of California, San Francisco, California 94143, USA.
Cancer. 2006 Nov 15;107(10):2384-91. doi: 10.1002/cncr.22262.
The University of California, San Francisco (UCSF) Cancer of the Prostate Risk Assessment (CAPRA) is a novel preoperative index which predicts the risk of biochemical recurrence after radical prostatectomy. The performance of the index is at least as good as the best available instruments based on clinical variables, and the 0 to 10 score is simple to calculate for both clinical and research purposes. This study used a large external dataset to validate CAPRA.
Data were abstracted from the Shared Equal Access Regional Cancer Hospital (SEARCH) database, a registry of men who underwent radical prostatectomy at 4 Veterans Affairs and 1 active military medical center. Of 2096 men in the database, 1346 (64%) had full data available to calculate the CAPRA score. Performance of the CAPRA score was assessed with proportional hazards regression, survival analysis, and the concordance (c) index.
Of the studied patients, 41% were non-Caucasian, and their mean age was 62 years. Twenty-six percent suffered recurrence; median follow-up among patients who did not recur was 34 months. The hazard ratio (HR) for each 1-point increase in CAPRA was 1.39 (95% CI [confidence interval], 1.31-1.46). The 5-year recurrence-free survival rate ranged from 86% for CAPRA 0-1 patients to 21% for CAPRA 7-10 patients. Increasing CAPRA scores were significantly associated with increasing risk of adverse pathologic outcomes. The c-index for CAPRA for the validation set was 0.68, compared with 0.66 for the original development set.
The UCSF-CAPRA accurately predicted both biochemical and pathologic outcomes after radical prostatectomy among a large, diverse, cohort of men. These results validated the effectiveness of this powerful and straightforward instrument.
加利福尼亚大学旧金山分校（UCSF）前列腺癌风险评估（CAPRA）是一种新型术前指标，可预测根治性前列腺切除术后生化复发的风险。该指标的表现至少与基于临床变量的最佳现有工具一样好，并且0至10分的评分对于临床和研究目的而言计算都很简单。本研究使用一个大型外部数据集对CAPRA进行验证。
数据从共享平等访问区域癌症医院（SEARCH）数据库中提取，该数据库是在4家退伍军人事务部和1家现役军事医疗中心接受根治性前列腺切除术的男性的登记册。数据库中的2096名男性中，有1346名（64%）有完整数据可用于计算CAPRA评分。采用比例风险回归、生存分析和一致性（c）指数评估CAPRA评分的表现。
在研究的患者中，41%为非白种人，平均年龄为62岁。26%的患者出现复发；未复发患者的中位随访时间为34个月。CAPRA每增加1分，风险比（HR）为1.39（95%置信区间[CI]，1.31 - 1.46）。5年无复发生存率从CAPRA 0 - 1分患者的86%到CAPRA 7 - 10分患者的21%不等。CAPRA评分增加与不良病理结果风险增加显著相关。验证集的CAPRA的c指数为0.68，而原始开发集为0.66。
UCSF - CAPRA在一大群多样化的男性中准确预测了根治性前列腺切除术后的生化和病理结果。这些结果验证了这种强大且简单的工具的有效性。
