title: External validation of University of California, San Francisco, Cancer of the Prostate Risk Assessment score.
abstract: OBJECTIVE
  In 2005, the University of California, San Francisco, proposed the Cancer of the Prostate Risk Assessment (UCSF-CAPRA) score to predict the risk of biochemical recurrence (BR) after radical prostatectomy. This study provides external validation and a modified version of the model using a large cohort of men treated with radical prostatectomy at a high-volume, tertiary referral center.
  
  
  METHODS
  From 1984 to 2006, 6737 men underwent radical prostatectomy at our institution for clinical Stage T1c-T3a prostate cancer with available follow-up information and no neoadjuvant or adjuvant therapy before BR. The BR-free survival was estimated using the Kaplan-Meier method and compared by UCSF-CAPRA score using the log-rank statistic. Performance of the UCSF-CAPRA was evaluated using Cox proportional hazards regression analysis and Harrell's concordance (c) index and compared with the Kattan nomogram. The UCSF-CAPRA score and final pathologic findings were assessed by odds ratios.
  
  
  RESULTS
  The 5-year BR-free survival rate was 83.1% overall and decreased from 94.4% for men with a UCSF-CAPRA score of 1 or less to 25.8% for those with a score of 7 or more (P <0.0001). The hazards ratio approximately doubled for each UCSF-CAPRA point until a score of 4, when the hazards ratio increased at a slower rate. The c-index of the UCSF-CAPRA and Kattan nomogram was 0.76 and 0.78, respectively. A greater UCSF-CAPRA score correlated with the final pathologic findings.
  
  
  CONCLUSIONS
  The UCSF-CAPRA performed well in this tertiary, referral-based cohort with a c-index similar to that of the Kattan nomogram. It remains an effective prognostic instrument for predicting the risk of biochemical recurrence after radical prostatectomy.
authors: Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
authors: Kevin H
authors: KH
authors: Zhao
authors: David J
authors: DJ
authors: Hernandez
authors: Misop
authors: M
authors: Han
authors: Elizabeth B
authors: EB
authors: Humphreys
authors: Leslie A
authors: LA
authors: Mangold
authors: Alan W
authors: AW
authors: Partin
mesh_terms: D002140:California; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen