Australian validation of the Cancer of the Prostate Risk Assessment Post-Surgical score to predict biochemical recurrence after radical prostatectomy

Kerri Beckmann, Michael O'Callaghan, Andrew Vincent, David Roder, Jeremy Millar, Sue Evans, John Mcneil, Kim Moretti

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Background: The Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) score is a simple post-operative risk assessment tool predicting disease recurrence after radical prostatectomy, which is easily calculated using available clinical data. To be widely useful, risk tools require multiple external validations. We aimed to validate the CAPRA-S score in an Australian multi-institutional population, including private and public settings and reflecting community practice. Methods: The study population were all men on the South Australian Prostate Cancer Clinical Outcomes Collaborative Database with localized prostate cancer diagnosed during 1998-2013, who underwent radical prostatectomy without adjuvant therapy (n=1664). Predictive performance was assessed via Kaplan-Meier and Cox proportional regression analyses, Harrell's Concordance index, calibration plots and decision curve analysis. Results: Biochemical recurrence occurred in 342 (21%) cases. Five-year recurrence-free probabilities for CAPRA-S scores indicating low (0-2), intermediate (3-5) and high risk were 95, 79 and 46%, respectively. The hazard ratio for CAPRA-S score increments was 1.56 (95% confidence interval 1.49-1.64). The Concordance index for 5-year recurrence-free survival was 0.77. The calibration plot showed good correlation between predicted and observed recurrence-free survival across scores. Limitations include the retrospective nature and small numbers with higher CAPRA-S scores. Conclusions: The CAPRA-S score is an accurate predictor of recurrence after radical prostatectomy in our cohort, supporting its utility in the Australian setting. This simple tool can assist in post-surgical selection of patients who would benefit from adjuvant therapy while avoiding morbidity among those less likely to benefit.

Original languageEnglish
Pages (from-to)E183-E188
Number of pages6
JournalANZ Journal of Surgery
Volume88
Issue number3
DOIs
Publication statusPublished - Mar 2018

Keywords

  • Cancer of the Prostate Risk Assessment Post-Surgical score
  • Post-operative
  • Prostate neoplasm
  • Radical prostatectomy
  • Risk assessment
  • Validation

Cite this

@article{0be6fcaf01054c7f9cd94febd8d3d057,
title = "Australian validation of the Cancer of the Prostate Risk Assessment Post-Surgical score to predict biochemical recurrence after radical prostatectomy",
abstract = "Background: The Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) score is a simple post-operative risk assessment tool predicting disease recurrence after radical prostatectomy, which is easily calculated using available clinical data. To be widely useful, risk tools require multiple external validations. We aimed to validate the CAPRA-S score in an Australian multi-institutional population, including private and public settings and reflecting community practice. Methods: The study population were all men on the South Australian Prostate Cancer Clinical Outcomes Collaborative Database with localized prostate cancer diagnosed during 1998-2013, who underwent radical prostatectomy without adjuvant therapy (n=1664). Predictive performance was assessed via Kaplan-Meier and Cox proportional regression analyses, Harrell's Concordance index, calibration plots and decision curve analysis. Results: Biochemical recurrence occurred in 342 (21{\%}) cases. Five-year recurrence-free probabilities for CAPRA-S scores indicating low (0-2), intermediate (3-5) and high risk were 95, 79 and 46{\%}, respectively. The hazard ratio for CAPRA-S score increments was 1.56 (95{\%} confidence interval 1.49-1.64). The Concordance index for 5-year recurrence-free survival was 0.77. The calibration plot showed good correlation between predicted and observed recurrence-free survival across scores. Limitations include the retrospective nature and small numbers with higher CAPRA-S scores. Conclusions: The CAPRA-S score is an accurate predictor of recurrence after radical prostatectomy in our cohort, supporting its utility in the Australian setting. This simple tool can assist in post-surgical selection of patients who would benefit from adjuvant therapy while avoiding morbidity among those less likely to benefit.",
keywords = "Cancer of the Prostate Risk Assessment Post-Surgical score, Post-operative, Prostate neoplasm, Radical prostatectomy, Risk assessment, Validation",
author = "Kerri Beckmann and Michael O'Callaghan and Andrew Vincent and David Roder and Jeremy Millar and Sue Evans and John Mcneil and Kim Moretti",
year = "2018",
month = "3",
doi = "10.1111/ans.13954",
language = "English",
volume = "88",
pages = "E183--E188",
journal = "ANZ Journal of Surgery",
issn = "1445-1433",
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}

Australian validation of the Cancer of the Prostate Risk Assessment Post-Surgical score to predict biochemical recurrence after radical prostatectomy. / Beckmann, Kerri; O'Callaghan, Michael; Vincent, Andrew; Roder, David; Millar, Jeremy; Evans, Sue; Mcneil, John; Moretti, Kim.

In: ANZ Journal of Surgery, Vol. 88, No. 3, 03.2018, p. E183-E188.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Australian validation of the Cancer of the Prostate Risk Assessment Post-Surgical score to predict biochemical recurrence after radical prostatectomy

AU - Beckmann, Kerri

AU - O'Callaghan, Michael

AU - Vincent, Andrew

AU - Roder, David

AU - Millar, Jeremy

AU - Evans, Sue

AU - Mcneil, John

AU - Moretti, Kim

PY - 2018/3

Y1 - 2018/3

N2 - Background: The Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) score is a simple post-operative risk assessment tool predicting disease recurrence after radical prostatectomy, which is easily calculated using available clinical data. To be widely useful, risk tools require multiple external validations. We aimed to validate the CAPRA-S score in an Australian multi-institutional population, including private and public settings and reflecting community practice. Methods: The study population were all men on the South Australian Prostate Cancer Clinical Outcomes Collaborative Database with localized prostate cancer diagnosed during 1998-2013, who underwent radical prostatectomy without adjuvant therapy (n=1664). Predictive performance was assessed via Kaplan-Meier and Cox proportional regression analyses, Harrell's Concordance index, calibration plots and decision curve analysis. Results: Biochemical recurrence occurred in 342 (21%) cases. Five-year recurrence-free probabilities for CAPRA-S scores indicating low (0-2), intermediate (3-5) and high risk were 95, 79 and 46%, respectively. The hazard ratio for CAPRA-S score increments was 1.56 (95% confidence interval 1.49-1.64). The Concordance index for 5-year recurrence-free survival was 0.77. The calibration plot showed good correlation between predicted and observed recurrence-free survival across scores. Limitations include the retrospective nature and small numbers with higher CAPRA-S scores. Conclusions: The CAPRA-S score is an accurate predictor of recurrence after radical prostatectomy in our cohort, supporting its utility in the Australian setting. This simple tool can assist in post-surgical selection of patients who would benefit from adjuvant therapy while avoiding morbidity among those less likely to benefit.

AB - Background: The Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) score is a simple post-operative risk assessment tool predicting disease recurrence after radical prostatectomy, which is easily calculated using available clinical data. To be widely useful, risk tools require multiple external validations. We aimed to validate the CAPRA-S score in an Australian multi-institutional population, including private and public settings and reflecting community practice. Methods: The study population were all men on the South Australian Prostate Cancer Clinical Outcomes Collaborative Database with localized prostate cancer diagnosed during 1998-2013, who underwent radical prostatectomy without adjuvant therapy (n=1664). Predictive performance was assessed via Kaplan-Meier and Cox proportional regression analyses, Harrell's Concordance index, calibration plots and decision curve analysis. Results: Biochemical recurrence occurred in 342 (21%) cases. Five-year recurrence-free probabilities for CAPRA-S scores indicating low (0-2), intermediate (3-5) and high risk were 95, 79 and 46%, respectively. The hazard ratio for CAPRA-S score increments was 1.56 (95% confidence interval 1.49-1.64). The Concordance index for 5-year recurrence-free survival was 0.77. The calibration plot showed good correlation between predicted and observed recurrence-free survival across scores. Limitations include the retrospective nature and small numbers with higher CAPRA-S scores. Conclusions: The CAPRA-S score is an accurate predictor of recurrence after radical prostatectomy in our cohort, supporting its utility in the Australian setting. This simple tool can assist in post-surgical selection of patients who would benefit from adjuvant therapy while avoiding morbidity among those less likely to benefit.

KW - Cancer of the Prostate Risk Assessment Post-Surgical score

KW - Post-operative

KW - Prostate neoplasm

KW - Radical prostatectomy

KW - Risk assessment

KW - Validation

UR - http://www.scopus.com/inward/record.url?scp=85018434240&partnerID=8YFLogxK

U2 - 10.1111/ans.13954

DO - 10.1111/ans.13954

M3 - Article

VL - 88

SP - E183-E188

JO - ANZ Journal of Surgery

JF - ANZ Journal of Surgery

SN - 1445-1433

IS - 3

ER -