You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History I1 Apr 2012162 MULTI-INSTITUTIONAL VALIDATION OF THE CAPRA-S SCORE TO PREDICT OUTCOMES AFTER RADICAL PROSTATECTOMY Sanoj Punnen, Stephen Freedland, Joseph Presti, Christopher Kane, Christopher Amling, Martha Terris, William Aaronson, Peter Carroll, and Matthew Cooperberg Sanoj PunnenSanoj Punnen San Francisco, CA More articles by this author , Stephen FreedlandStephen Freedland Durham, NC More articles by this author , Joseph PrestiJoseph Presti Palo Alto, CA More articles by this author , Christopher KaneChristopher Kane San Diego, CA More articles by this author , Christopher AmlingChristopher Amling Portland, OR More articles by this author , Martha TerrisMartha Terris Augusta, GA More articles by this author , William AaronsonWilliam Aaronson Los Angeles, CA More articles by this author , Peter CarrollPeter Carroll San Francisco, CA More articles by this author , and Matthew CooperbergMatthew Cooperberg San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.213AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The UCSF Cancer of the Prostate Risk Assessment - post-Surgical (CAPRA-S) score is a novel risk assessment tool that uses postoperative pathological data to predict the risk of recurrence post radical prostatectomy. The objective of this study was to validate its use in a large external database. METHODS The Shared Equal Access Regional Cancer Hospital (SEARCH) database is a registry of men who underwent radical prostatectomy at one of 4 Veterans Affairs medical centers. 2078 (94%) of the 2,211 men in SEARCH had complete data available to calculate a CAPRA-S score. The CAPRA-S is determined by adding up to 3 points each for PSA and pathological Gleason score, 2 points each for positive surgical margins and seminal vesicle invasion and 1 point each for extracapsular extension and lymph node involvement. Performance of the CAPRA-S score was assessed using proportional hazards regression, and compared to the Stephenson nomogram by the concordance (c) index, calibration plots and decision curves analysis. RESULTS Among this cohort, the mean age was 62 (SD 6.3) years and 33.3 % of men recurred. Median follow up was 60.7 months among men who did not recur. The hazard ratio (HR) for each one-point increase in the CAPRA-S score was 1.42 (95%CI 1.37-1.46). The 5-year progression free probability for those patients with a CAPRA-S score of 0-2, 3-5 and 6-10 (a priori defined as low-, intermediate-, and high-risk from the initial CAPRA-S development paper) were 72%, 41%, and 14%, respectively. The CAPRA-S c-index was 0.75 in this validation set, compared to a c-index of 0.73 for the Stephenson nomogram and 0.77 for CAPRA-S in the original development set. The CAPRA-S score performed better than the Stephenson nomogram on both calibration plots and decision curves analysis. CONCLUSIONS In this external validation study the CAPRA-S score accurately predicted recurrence after radical prostatectomy in a large cohort of men better than another published nomogram. The score is an effective prognostic tool with potential broad applicability in the clinical and research settings. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e67 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sanoj Punnen San Francisco, CA More articles by this author Stephen Freedland Durham, NC More articles by this author Joseph Presti Palo Alto, CA More articles by this author Christopher Kane San Diego, CA More articles by this author Christopher Amling Portland, OR More articles by this author Martha Terris Augusta, GA More articles by this author William Aaronson Los Angeles, CA More articles by this author Peter Carroll San Francisco, CA More articles by this author Matthew Cooperberg San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...