CAPRA score: accurate predictor of prostate cancer endpoints

The CAPRA scoring system, when used in a large cohort of patients with clinically localized prostate cancer, was found to be an accurate predictor of outcome, adding value for its use in assessing risk and for stratifying patients.

Developed with data from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry, the CAPRA scoring system had not been previously assessed for ability to predict metastasis or mortality in patients who had undergone radical prostatectomy. It has also not been validated for predictive value among patients who had received another type of treatment.

For this current study, the researchers evaluated 10,627 men with prostate cancer who had undergone primary radical prostatectomy, radiation therapy, androgen deprivation monotherapy, or active surveillance with six months of follow-up post-treatment.

According to their CAPRA scores, 48.7% of patients were at low risk, 38.0% were at intermediate risk and 13.3% were at high risk. Those treated with androgen deprivation monotherapy or external beam radiation therapy tended to have higher CAPRA scores, the researchers said.

An increase of one point on the CAPRA scale was linked with an increased risk of bone metastases, increased risk of cancer-specific mortality and increased risk of all-cause mortality, the researcher reported.

Additionally, an increase of one point on the CAPRA score was linked with increased risk of prostate cancer-specific mortality for each treatment group.

“The CAPRA score … is, to our knowledge, the first instrument that uses information available at time of diagnosis to predict accurately the development of metastases, cancer-specific mortality, and all-cause mortality, irrespective of primary treatment,” the researchers wrote.

Cooperberg. J Natl Cancer Inst. 2009;101:878-887.