CAPRA-S predicts outcome for adjuvant and salvage external beam radiotherapy after radical prostatectomy

Authors

  • Michel Zimmermann Department of Radiation Oncology, Centre hospitalier de l’Université de Montréal, Hôpital Notre-Dame, Montréal, QC, Canada
  • Guila Delouya Department of Radiation Oncology, Centre hospitalier de l’Université de Montréal, Hôpital Notre-Dame, Montréal, QC, Canada CRCHUM-Centre de recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
  • Abdullah M. Alenizi Section of Urology, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
  • Emad Rajih Section of Urology, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
  • Kevin C. Zorn Section of Urology, Department of Surgery, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
  • Daniel Taussky Département de Radio-Oncologie, Centre Hospitalier de l’Université de Montréal (CHUM) - Hôpital Notre-Dame, Montréal, Québec, Canada

DOI:

https://doi.org/10.5489/cuaj.3365

Abstract

Introduction: We aimed to evaluate the predictive value of the Cancer of the Prostate Risk Assessment Postsurgical Score (CAPRA-S) for patients treated with radical prostatectomy followed by subsequent external beam radiotherapy (EBRT).

Methods: A total of 373 patients treated with EBRT between January 2000 and June 2015 were identified in the institutional database. Followup and complete CAPRA-S score were available for 334 (89.5%) patients. CAPRA-S scores were sorted into previously defined categories of low- (score 0‒2), intermediate- (3‒5), and high-risk (6‒12). Time to biochemical recurrence (BCR) was defined as prostate-specific antigen (PSA) >0.20 ng/mL after EBRT. Survival analyses were performed using the Kaplan-Meier method and comparisons were made using the log-rank test.

Results: Overall median time from surgery to EBRT was 18 months (interquartile range [IQR] 8‒36) and median followup since EBRT was 48 months (IQR 28‒78). CAPRA-S predicted time to BCR (<0.001), time to palliative androgen-deprivation therapy (ADT) (p=0.017), and a trend for significantly predicting overall survival (OS, p=0.058). On multivariate analysis, the CAPRA-S was predictive of time to BCR only (low-risk vs. intermediate-risk; hazard ratio [HR] 0.14, 95% confidence interval [CI] 0.043‒0.48, p=0.001). The last PSA measurement before EBRT as a continuous and grouped variable proved highly significant in predicting all outcomes tested, including OS (p≤0.002).

Conclusions: CAPRA-S predicts time to BCR and freedom from palliative ADT, and is borderline significant for OS. Together with the PSA before EBRT, CAPRA-S is a useful, predictive tool. The main limitation of this study is its retrospective design.

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Published

2016-04-18

How to Cite

Zimmermann, M., Delouya, G., Alenizi, A. M., Rajih, E., Zorn, K. C., & Taussky, D. (2016). CAPRA-S predicts outcome for adjuvant and salvage external beam radiotherapy after radical prostatectomy. Canadian Urological Association Journal, 10(3-4), 132–6. https://doi.org/10.5489/cuaj.3365

Issue

Section

Original Research