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Research Article

Factors Affecting Biochemical Recurrence After Radical Prostatectomy and Validity of CAPRA Score in Predicting Biochemical Recurrence


1 Izmir Tepecik Training and Research Hospital, Department of Urology, Izmir, Türkiye
2 Bitlis State Hospital, Department of Urology, Bitlis, Türkiye
3 Izmir Katip Celebi University Faculty of Medicine, Department of Biostatistics, Izmir, Türkiye


DOI : 10.33719/nju1540186
New J Urol. 2024;19(3):136-144.

Abstract

Objective: Biochemical recurrence (BCR) after prostate cancer (PCa) treatment is undesirable.
It is important to inform a patient about BCR in preoperative evaluation. We aimed to
demonstrate the effectiveness of the (The Prostate Cancer Risk Assessment) CAPRA score used
to predict this situation in our study.

Material and Methods: The study included 348 patients who underwent Radical Prostatectony
(RP) for localized PCa. Demographic, preoperative and postoperative data were collected.
CAPRA score based on preoperative total PSA value, Gleason Score, clinical T stage, percentage
of positive biopsy cores and age was calculated using these data. BCR was defined as a total PSA
value >0.2 ng/dL for two consecutive times after RP. Follow-up periods, recurrence status and
time of recurrence were recorded.

Results: BCR positivity was detected in 60 (17.2%) of 348 patients. In univariate analyses, PSA
level, lesion volume on MRI, ISUP grade, D’Amico risk classification, Seminal vesicule invasion
(SVI) and CAPRA score were statistically significant in the groups. In multivariate analyses,
PSA level, Neutrophile Lymphocyte Ratio, lesion dimension, intermediate risk according to
D’amico classification, Extraprostatic extension (EPE) showed differences between both groups.
The probability of biochemical progression-free in CAPRA risk groups shows a significant
decrease in the probability of biochemical progression-free in the long term as risk increases in
CAPRA risk groups: 91.4% in the low-risk group, 77.8% in the intermediate-risk group and only
61.7% in the high-risk group at 80-month follow-up.

Conclusion: CAPRA scoring system should be supported by MpMRI findings and a new
nomogram should be developed with these findings.

Keywords: CAPRA score, radical prostatectomy, biochemical recurrence, prostate cancer


Abstract

Objective: Biochemical recurrence (BCR) after prostate cancer (PCa) treatment is undesirable.
It is important to inform a patient about BCR in preoperative evaluation. We aimed to
demonstrate the effectiveness of the (The Prostate Cancer Risk Assessment) CAPRA score used
to predict this situation in our study.

Material and Methods: The study included 348 patients who underwent Radical Prostatectony
(RP) for localized PCa. Demographic, preoperative and postoperative data were collected.
CAPRA score based on preoperative total PSA value, Gleason Score, clinical T stage, percentage
of positive biopsy cores and age was calculated using these data. BCR was defined as a total PSA
value >0.2 ng/dL for two consecutive times after RP. Follow-up periods, recurrence status and
time of recurrence were recorded.

Results: BCR positivity was detected in 60 (17.2%) of 348 patients. In univariate analyses, PSA
level, lesion volume on MRI, ISUP grade, D’Amico risk classification, Seminal vesicule invasion
(SVI) and CAPRA score were statistically significant in the groups. In multivariate analyses,
PSA level, Neutrophile Lymphocyte Ratio, lesion dimension, intermediate risk according to
D’amico classification, Extraprostatic extension (EPE) showed differences between both groups.
The probability of biochemical progression-free in CAPRA risk groups shows a significant
decrease in the probability of biochemical progression-free in the long term as risk increases in
CAPRA risk groups: 91.4% in the low-risk group, 77.8% in the intermediate-risk group and only
61.7% in the high-risk group at 80-month follow-up.

Conclusion: CAPRA scoring system should be supported by MpMRI findings and a new
nomogram should be developed with these findings.

Keywords: CAPRA score, radical prostatectomy, biochemical recurrence, prostate cancer

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