EURURO Vol. 71 No. 5

705 844

Brief Correspondence
The CAPRA Score at 10 Years: Contemporary Perspectives and
Analysis of Supporting Studies
Jonathan S. Brajtbord Michael S. Leapman Matthew R. Cooperberg
a Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA; bDepartment of Epidemiology and Biostatistics,
UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
1. Rationale for the Cancer of Prostate Risk
Assessment score
Accurate risk stratification of men at the time of diagnosis of
prostate cancer (PCa) is crucial in generating well-informed
clinical decisions. In the context of research, clinical
investigation and its interpretation is advanced by a faithful
assortment of patients along a spectrum of risk. Tumor
characteristics such as grade, extent, and prostate-specific
antigen (PSA) level offer independent prediction of oncol-
ogic outcomes, and when incorporated into multivariable
models, they offer better accuracy when compared with
ava ilable at
journal homepage:
Article info
Article history:
Accepted August 30, 2016
Associate Editor:
Giacomo Novara
Keywords:
Prostate cancer
Prostate cancer outcomes
Risk calculator
Abstract
Tools that appraise oncologic risk are a critical component of research and clinical
management of prostate cancer (PCa). We performed a PubMed/Medline search to
review the concept, design, and clinical validation of the Cancer of the Prostate Risk
Assessment (CAPRA) score and similar systems in the postsurgical (CAPRA-S) and
primary androgen deprivation therapy (Japan CAPRA [J-CAPRA]) settings. We included
reports addressing the CAPRA (n = 13), CAPRA-S (n = 4), and J-CAPRA ( n = 5) scores.
External validation studies for the CAPRA score have yielded favorable clinical perfor-
mance in both academic and community cohorts, with concordance index (c-index) for
biochemical recurrence (BCR) after definitive treatment in the range of 0.66–0.81.
Validation studies addressing the postsurgical CAPRA-S score have demonstrated favor-
able prediction of distant end points (c-index for BCR: 0.73–0.80; prostate cancer–
specific mortality [PCSM]: 0.75–0.88). The J-CAPRA score was evaluated in 1378 men
treated with primary ADT and demonstrated excellent discrimination (c-index
for progression-free survival: 0.80–0.89; PCSM: 0.820–0.836; overall survival:
0.665–0.700). The CAPRA score and its derivatives have demonstrated robust clinical
discrimination in a decade of validation studies. The CAPRA score and similar multivari-
able stratification systems are posed to replace prior older and less accurate risk group
categories.
Patient summary: We addressed the development of the Cancer of the Prostate Risk
Assessment (CAPRA) score, its methodology, and its supporting studies. The CAPRA score
and similarly designed tools have yielded strong performance in the prediction of
numerous prostate cancer end points.
# 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.
* Corresponding author. Department of Urology, University of California, San Francisco, Mailcode
1695, 550 16th Street, 6th floor, San Francisco, CA 94143, USA. Tel. +1 415 885 3660;
Fax: +1 415 476 5366.
E-mail address: (M.R. Cooperberg).
0302-2838/# 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.