1. Validation of the STAR-CAP Clinical Prognostic System for Predicting Biochemical Recurrence, Metastasis, and Cancer-specific Mortality After Radical Prostatectomy in a European Cohort
- Author
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Randi Pose, Markus Graefen, Zhe Tian, Reha-Baris Incesu, Christoph Würnschimmel, Mike Wenzel, Derya Tilki, and Pierre I. Karakiewicz
- Subjects
Oncology ,Biochemical recurrence ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Metastasis ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Prostate ,Internal medicine ,medicine ,Humans ,Stage (cooking) ,Neoplasm Staging ,Retrospective Studies ,Prostatectomy ,Receiver operating characteristic ,business.industry ,Cancer ,Prostatic Neoplasms ,Prostate-Specific Antigen ,medicine.disease ,Prognosis ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Neoplasm Grading ,business - Abstract
The proposed international staging collaboration for cancer of the prostate (STAR-CAP) clinical prognostic system for prostate cancer predicts cancer-specific mortality (CSM) for patients for whom active treatment, such as radical prostatectomy (RP), is planned. Until now, no validation of STAR-CAP has been performed. We retrospectively analyzed data from our institutional database for 19 552 patients treated with RP between 1992 and 2015. We applied the STAR-CAP point assignment criteria to calculate total individual scores and then classified patients according to the STAR-CAP stage groups ranging from IA (lowest risk) to IIIC (highest risk). We evaluated biochemical recurrence (BCR)-free survival, metastasis-free survival (MFS), and cancer-specific survival (CSS) stratified by STAR-CAP stage groups over 10 yr, calculated the area under the receiver operating characteristics curve (AUC), and performed decision curve analyses to assess the ability of STAR-CAP to predict these outcomes after fitting the data from our single-institution data set. STAR-CAP performed well in stratifying individual survival outcomes for BCR-free survival, MFS, and CSS for each stage group in Kaplan-Meier analyses (p 0.001 between groups). The AUC for prediction of BCR, metastasis, and CSM at 10 yr was 0.73, 0.84, and 0.75, respectively. Our findings validate the performance of STAR-CAP for European patients treated with RP. PATIENT SUMMARY: We validated the STAR-CAP system for predicting cancer outcomes after removal of the prostate. Our results show that the system performs well and could help in counseling patients with prostate cancer.
- Published
- 2021