Objectives: The aim of the present study was external validation to determine whether the Cancer of the Prostate Risk Assessment (CAPRA) score predicts biochemical relapse (BCR) after radical prostatectomy (RP) in Japanese patients. Methods: From 1995 to 2008, 503 Japanese patients undergoing RP for clinically localized prostate cancer were included in the validation cohort. The BCR-free rate was estimated using the Kaplan-Meier method. Performance of the CAPRA score was assessed using Cox proportional hazards regression models, concordance index (c-index) and calibration plots. Results: Unlike the results in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) cohort, the BCR-free rate and the hazard ratio for CAPRA score 4 were inversely better than those for CAPRA scores 2 and 3 in Japanese patients. The c-index of the CAPRA score was 0.673. The calibration plot demonstrated that the CAPRA score was generally well calibrated. Conclusions: In Japanese patients, the CAPRA score can predict BCR after RP only to some degree. Although our c-index is comparable with the c-index of 0.66 in the original CaPSURE cohort, it is lower than the c-indices reported in other validation cohorts, which range from 0.68 to 0.81. The CAPRA score may not predict BCR after RP in Japanese patients as accurately as it did in Western patients.

Keywords:
Biochemical relapse, CAPRA, Japanese patients, Prostate cancer, Radical prostatectomy
1.
Han M, Partin AW, Zahurak M, Piantadosi S, Epstein JI, Walsh PC: Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol 2003;169:517–523.
2.
Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC: Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999;281:1591–1597.
3.
D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, Tomaszewski JE, Renshaw AA, Kaplan I, Beard CJ, Wein A: Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 1998;280:969–974.
4.
Stephenson AJ, Scardino PT, Eastham JA, Bianco FJ Jr, Dotan ZA, Fearn PA, Kattan MW: Preoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Natl Cancer Inst 2006;98:715–717.
5.
Cooperberg MR, Pasta DJ, Elkin EP, Litwin MS, Latini DM, Du Chane J, Carroll PR: The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol 2005;173:1938–1942.
6.
Cooperberg MR, Freedland SJ, Pasta DJ, Elkin EP, Presti JC Jr, Amling CL, Terris MK, Aronson WJ, Kane CJ, Carroll PR: Multiinstitutional validation of the UCSF cancer of the prostate risk assessment for prediction of recurrence after radical prostatectomy. Cancer 2006;107:2384–2391.
7.
May M, Knoll N, Siegsmund M, Fahlenkamp D, Vogler H, Hoschke B, Gralla O: Validity of the CAPRA score to predict biochemical recurrence-free survival after radical prostatectomy. Results from a European multicenter survey of 1,296 patients. J Urol 2007;178:1957–1962.
8.
Zhao KH, Hernandez DJ, Han M, Humphreys EB, Mangold LA, Partin AW: External validation of University of California, San Francisco, Cancer of the Prostate Risk Assessment score. Urology 2008;72:396–400.
9.
Loeb S, Carvalhal GF, Kan D, Desai A, Catalona WJ: External validation of the cancer of the prostate risk assessment (CAPRA) score in a single-surgeon radical prostatectomy series. Urol Oncol 2010, E-pub ahead of print.
10.
Ohshima A, Kuroishi T, Tajima K: Cancer Statistics – Morbidity/Mortality/Prognosis. Tokyo, Shinohara, 2004.
11.
Cancer Registration Committee of the Japanese Urological Association: Clinicopathological statistics on registered prostate cancer patients in Japan: 2000 report from the Japanese Urological Association. Int J Urol 2005;12:46–61.
12.
Center for Cancer Control and Information Services, National Cancer Center (data in Japanese). http://ganjoho.jp/professional/statistics/statistics.html (accessed April 2011).
13.
Cooperberg MR, Broering JM, Carroll PR: Risk assessment for prostate cancer metastasis and mortality at the time of diagnosis. J Natl Cancer Inst 2009;101:878–887.
14.
Smith D, Bullock A, Catalona W: Racial differences in operating characteristics of prostate cancer screening tests. J Urol 1997;158:1861–1866.
15.
Morton RA Jr: Racial differences in adenocarcinoma of the prostate in North American men. Urology 1994;44:637–645.
16.
Shelley MD, Kumar S, Wilt T, Staffurth J, Coles B, Mason MD: A systematic review and meta-analysis of randomised trials of neo-adjuvant hormone therapy for localised and locally advanced prostate carcinoma. Cancer Treat Rev 2005;35:9–17.
17.
Amling CL, Bergstralh EJ, Blute ML, Slezak JM, Zincke H: Defining prostate specific antigen progression after radical prostatectomy: what is the most appropriate cut point? J Urol 2001;165:1146–1151.
© 2012 S. Karger AG, Basel
2012
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