Analysis of three pre-operative risk assessment tools for prostate cancer in a local Chinese cohort undergoing radical prostatectomy

Abstract

OBJECTIVES: To compare the performance of the CAPRA score, Kattan nomogram and Stephenson nomogram in a local Chinese cohort of patients with prostate cancer undergoing radical prostatectomy. METHODS: This is a review of a prospective cohort of men who underwent radical prostatectomy for prostate cancer. CAPRA score, Kattan score and Stephenson score were calculated by analysis of variables for predicting biochemical recurrence. Biochemical recurrence was defined as PSA more than 0.2 ng/mL or secondary treatment for a rising PSA. Performance of the three risk assessment tools was evaluated using Harrell’s concordance index, plotting calibration curves, and constructing decision analysis curves. RESULTS: Two hundred and eighty-seven men who underwent radical prostatectomy from 1998 to 2012 were recruited. Concordance index for the three assessment tools were high (0.69 for CAPRA score, 0.71 for Kattan score, 0.73 for Stephenson score). The Stephenson score had the best calibration plot in predicting biochemical free recurrence probability. The Stephenson score also had a better performance across various threshold probability in the decision curve analysis. CONCLUSIONS: All three assessment tools were validated in our local Chinese cohort. Stephenson score had the best performance in predicting biochemical free recurrence probability and in the decision curve analysis.