title: Evaluation of biochemical recurrence-free survival after radical prostatectomy by cancer of the prostate risk assessment post-surgical (CAPRA-S) score.
abstract: BACKGROUND
  The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model.
  
  
  METHODS
  CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index).
  
  
  RESULTS
  BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was 51.7±33.0 months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P=0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively.
  
  
  CONCLUSIONS
  Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.
authors.affiliation: Urology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey E-mail : kaanaktas73@hotmail.com.
authors.forename: Binhan Kagan
authors.initials: BK
authors.lastname: Aktas
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Ozden
authors.forename: Suleyman
authors.initials: S
authors.lastname: Bulut
authors.forename: Suleyman
authors.initials: S
authors.lastname: Tagci
authors.forename: Guven
authors.initials: G
authors.lastname: Erbay
authors.forename: Cevdet Serkan
authors.initials: CS
authors.lastname: Gokkaya
authors.forename: Mehmet Murat
authors.initials: MM
authors.lastname: Baykam
authors.forename: Ali
authors.initials: A
authors.lastname: Memis
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000401:mortality*; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate
chemical_list: D017430:Prostate-Specific Antigen