Abstract
Background: Biochemical recurrence (BCR) can be seen in the
early or late period after radical prostatectomy (RP). Various models
have been developed to predict BCR.
Objective: In our study we evaluated accuracy of four
pre-operative models (GP score, PRIX, D’Amico risk classification,
CAPRA) in predicting BCR after RP in Turkish patients.
Methods: Age, preoperative total prostate specific antigen
(PSA) values, clinical stages, total number of cores taken in biopsy,
number of positive cores, preoperative biopsy Gleason score (GS),
follow-up time and presence of BCR after RP were recorded. BCR was
defined as a total PSA value > 0.2 ng / dl twice
consecutively after RP. Classifications or scoring was performed
according to pre-operative models. The 1, 3 and 5 year (yr) BCR-free
rates of the patients were determined for each model. Also the accuracy
of four predictive models for predicting 1, 3 and 5-yr BCR was
evaluated.
Results: For all pre-operative models there was statistically
significant difference between risk groups in BCR free rates at 1, 3 and
5-yr after RP (p<0.001). The Harrell’s concordance index for
1-yr BCR predictions was 0,802, 0,831, 0,773 and 0,745 for the GP score,
PRIX, CAPRA and D’Amico and respectively. For 3-yr BCR predictions it
was 0,798, 0,791, 0,723 and 0,714 for the GP score, PRIX, CAPRA and
D’Amico and respectively. Finally, The Harrell’s concordance index for
5-yr BCR predictions was 0,778, 0,771, 0,702 and 0,693 for the GP score,
PRIX, CAPRA and D’Amico and respectively.
Conclusion: In prediction of BCR, accuracy of GP scoring and
PRIX seems slightly higher than CAPRA and D’Amico risk classification.
Surely our results should be supported by head to head comparisons with
in other larger cohorts
Keywords: Prostate cancer, preoperative predictive models,
radical prostatectomy, biochemical recurrence