Open AccessModified J‐CAPRA scoring system in predicting treatment outcomes of metastatic prostate cancer patients undergoing androgen deprivation therapy
Author(s) -
Lim Jasmine,
Hinotsu Shiro,
Onozawa Mizuki,
Malek Rohan,
Sundram Murali,
Teh Guan C.,
Ong TengAik,
Thevarajah Shankaran,
Zainal Rohana,
Khoo Say C.,
Omar Shamsuddin,
Nasuha Noor A.,
Akaza Hideyuki
Publication year - 2020
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.3548
Subject(s) - prostate cancer , medicine , capra , oncology , prostate , androgen deprivation therapy , stage (stratigraphy) , cancer , biology , ecology , paleontology
The J‐CAPRA score is an assessment tool which stratifies risk and predicts outcome of primary androgen deprivation therapy (ADT) using prostate‐specific antigen, Gleason score, and clinical TNM staging. Here, we aimed to assess the generalisability of this tool in multi‐ethnic Asians. Performance of J‐CAPRA was evaluated in 782 Malaysian and 16,946 Japanese patients undergoing ADT from the Malaysian Study Group of Prostate Cancer (M‐CaP) and Japan Study Group of Prostate Cancer (J‐CaP) databases, respectively. Using the original J‐CAPRA, 69.6% metastatic (M1) cases without T and/or N staging were stratified as intermediate‐risk disease in the M‐CaP database. To address this, we first omitted clinical T and N stage variables, and calculated the score on a 0–8 scale in the modified J‐CAPRA scoring system for M1 patients. Notably, treatment decisions of M1 cases were not directly affected by both T and N staging. The J‐CAPRA score threshold was adjusted for intermediate (modified J‐CAPRA score 3–5) and high‐risk (modified J‐CAPRA score ≥6) groups in M1 patients. Using J‐CaP database, validation analysis showed that overall survival, prostate cancer‐specific survival, and progression‐free survival of modified intermediate and high‐risk groups were comparable to those of original J‐CAPRA ( p > 0.05) with Cohen's coefficient of 0.65. Around 88% M1 cases from M‐CaP database were reclassified into high‐risk category. Modified J‐CAPRA scoring system is instrumental in risk assessment and treatment outcome prediction for M1 patients without T and/or N staging.