The relationship between the CAPRA-S and the time of biochemical recurrence following radical prostatectomy

Year 2021, Volume: 16 Issue: 3, 254 - 261, 22.10.2021

Süleyman Tağcı Cüneyt Özden , Yalçın Kızılkan , Samet Şenel , Doruk Demirel , Binhan Aktaş Cevdet Gökkaya Süleyman Bulut

https://doi.org/10.33719/yud.2021;16-3-908452

Abstract

Objective: In this study, we aimed to evaluate the relationship between biochemical recurrence time and the “cancer of the prostate risk assessment post-surgery” score (CAPRA-S) after radical prostatectomy (RP).
Material and Methods: Retrospective evaluation was made of the records of 328 patients applied with RP for a diagnosis of clinically localized prostate cancer. The patients were separated into groups according to the CAPRA-S score determined according to the preoperative PSA level and pathological characteristics of the RP specimen and the biochemical recurrence time after RP.
Results: The mean follow-up period was 76.9±34.5 months. Biochemical recurrence was determined in 23.2% (n:69) of the cases, as early recurrence in 71% (n:49) and late in 29% (n:20). According to the CAPRA-S score, 186 (62.4%) patients were classified as low risk, 66 (22.1%) as moderate risk, and 46 (15%) as high risk. The 3 and 5-year BRFS rates of all the patients were 88.9% and 81.8% respectively. Patients with a low CAPRA-S score were determined to have a statistically significantly higher 3 and 5-year BRFS rate than patients in the moderate and high groups. Early biochemical recurrence after RP was statistically significantly correlated only with lymph node involvement (OR: 2.42, 95% CI: 1.07-5.47, p=0.03).
Conclusion: This study showed that the CAPRA-S score, which is effective in predicting the risk of biochemical recurrence after RP, was not effective in predicting the time of biochemical recurrence after RP.

Keywords

Biochemical recurrence , CAPRA-S score , prostate cancer , radical prostatectomy

CAPRA-S ile radikal prostatektomi sonrası biyokimyasal rekürrens zamanı arasındaki ilişki

Abstract

Amaç: Radikal prostatektomi (RP) sonrası biyokimyasal nüks süresi ile “ameliyat sonrası prostat risk değerlendirme” skoru (CAPRA-S) arasındaki ilişkiyi değerlendirmek.
Gereç ve Yöntemler: Klinik lokalize prostat kanseri tanısı nedeniyle RP uygulanan 328 hastanın verileri retrospektif olarak değerlendirildi. Hastalar preoperatif PSA düzeyine ve RP spesmeninin patolojik özellikleri ve RP sonrası biyokimyasal nükse kadar geçen süre ile belirlenen CAPRA-S skoruna göre gruplara ayrıldı.
Bulgular: Ortalama takip süresi 76.9 ± 34.5 aydı. Biyokimyasal nüks, olguların % 23,2’sinde (n: 69) saptandı. Bunların % 71’inde (n: 49) erken, % 29’unda (n: 20) geç nüks saptandı. CAPRA-S skoruna göre 186 (% 62,4) hasta düşük riskli, 66 (% 22,1) orta riskli ve 46 (% 15) hasta yüksek riskli olarak sınıflandırıldı. Tüm hastaların 3 ve 5 yıllık biyokimyasal nükssüz sağkalım oranları sırasıyla % 88,9 ve % 81,8 olarak belirlendi. Düşük CAPRA-S skoruna sahip hastaların, orta ve yüksek gruptaki hastalara göre istatistiksel olarak anlamlı derecede daha yüksek 3 ve 5 yıllık biyokimyasal nükssüz sağkalım oranına sahip olduğu belirlendi. RP sonrası erken biyokimyasal rekürrensin sadece lenf nodu tutulumu ile istatistiksel olarak anlamlı korelasyon gösterdiği belirlendi (OR: 2.42, % 95 CI: 1.07-5.47, p = 0.03).
Sonuç: Bu çalışmanın sonuçları, RP sonrası biyokimyasal rekürrens riskini tahmin etmede etkili olan CAPRA-S skorunun RP sonrası biyokimyasal rekürrens zamanını tahmin etmede etkili olmadığını göstermiştir.

Keywords

Biyokimyasal nüks , CAPRA-S skoru , prostat kanseri , radikal prostatektomi

References

• 1. Siegel RL, Miller KD, Jemal A. Cancer statistics. CA Cancer J Clin. 2018;68(1):7-30.
• 2. Donovan J, Hamdy F, Neal D, et al. ProtecT Study Group. Prostate Testing for Cancer and Treatment (ProtecT) feasibility study. Health Technol Assess. 2003;7(14):1-88.
• 3. Busch J, Stephan C, Herold A, et al. Long-term oncological and continence outcomes after laparoscopic radical prostatectomy: a single-centre experience. BJU Int. 2012;110(11): 985-90.
• 4. Moul JW. Prostate specific antigen only progression of prostate cancer. J Urol. 2000;163(6):1632-42.
• 5. Freedland SJ, Humphreys EB, Mangold LA et al. Time to prostate specific antigen recurrence after radical prostatectomy and risk of prostate cancer specific mortality. J Urol. 2006;176:1404-8.
• 6. Cooperberg MR, Hilton JF, Carroll PR. The CAPRA-S score: A straightforward tool for improved prediction of outcomes after radical prostatectomy. Cancer. 2011;117(22):5039-46.
• 7. Seong KT, Lim JH, Park CM, et al. External validation of the cancer of the prostate risk assessment-s score in koreans undergoing radical prostatectomy. Korean J Urol. 2013;54(7):433-6.
• 8. Punnen S, Freedland SJ, Presti JC Jr, et al. Multi-institutional validation of the CAPRA-S score to predict disease recurrence and mortality after radical prostatectomy. Eur Urol. 2014;65(6):1171-7.
• 9. Hu XH, Cammann H, Meyer HA, et al. Risk prediction models for biochemical recurrence after radical prostatectomy using prostate-specific antigen and Gleason score. Asian J Androl. 2014;16(6):897-901.
• 10. Isbarn H, Wanner M, Salomon G, et al. Long-term data on the survival of patients with prostate cancer treated with radical prostatectomy in the prostate-specific antigen era. BJU Int. 2010;106(1):37-43.
• 11. Bratu OG, Diaconu CC, Mischianu DLD, et al. Therapeutic options in patients with biochemical recurrence after radical prostatectomy. Exp Ther Med. 2019 ;18(6):5021-5025.
• 12. Dillioglugil O, Leibman BD, Kattan MW, et al. Hazard rates for progression after radical prostatectomy for clinically localized prostate cancer. Urology 1997;50(1):93-9.
• 13. Simmons MN, Stephenson AJ, Klein EA. Natural history of biochemical recurrence after radical prostatectomy: risk assessment for secondary therapy. Eur Urol. 2007;51(5):1175-84.
• 14. Kattan MW, Wheeler TM, Scardino PT. Postoperative nomogram for disease recurrence after radical prostatectomy for prostate cancer. J Clin Oncol. 1999;17(5):1499-507.
• 15. Brockman JA, Alanee S, Vickers AJ, et al. Nomogram Predicting Prostate Cancer-specific Mortality for Men with Biochemical Recurrence After Radical Prostatectomy. Eur Urol. 2015;67(6):1160-1167.
• 16. Hernández Hernández C, Kim Lee D, Sanchez Pérez M, et al. Accuracy of CAPRA-S Score for Predicting Long-Term Biochemical Progression After Radical Prostatectomy. Clin Genitourin Cancer 2019;17(3): e645-e649.
• 17. Pound CR, Partin AW, Eisenberger MA, et al. Natural history of progression after PSA elevation following radical prostatectomy. JAMA. 1999; 281(17):1591-7.
• 18. Shahabi A, Satkunasivam R, Gill IS, et al. Predictors of time to biochemical recurrence in a radical prostatectomy cohort within the PSA-era. Can Urol Assoc J. 2016;10(1-2): E17-22.
• 19. Ward JF, Blute ML, Slezak J, et al. The long-term clinical impact of biochemical recurrence of prostate cancer 5 or more years after radical prostatectomy. J Urol 2003;170(5):1872-6.
• 20. Sundi D, Wang V, Pierorazio PM, et al. Identification of men with the highest risk of early disease recurrence after radical prostatectomy. Prostate. 2014;74(6):628-36.
• 21. Kinčius M, Matjošaitis AJ, Trumbeckas D, et al. Independent predictors of biochemical recurrence after radical prostatectomy: a single center experience. Cent European J Urol. 2011;64(1):21-5.
• 22. Molitierno J, Evans A, Mohler JL, et al. Characterization of biochemical recurrence after radical prostatectomy. Urol Int. 2006;77(2):130-4.