Background
Methods
Search strategy
Study selection
Patient population | Patients with Prostate Cancer with available CAPRA score |
---|---|
Intervention | Having a radical prostatectomy |
Comparison intervention | With or without control group |
Outcomes | Biochemical-recurrence-free survival |
Study type | Prospective or retrospective study presenting hazard ratio and/or survival curves |
Data extraction
Assessing clinical validity
Assessing clinical utility
Survival estimation
Utility scores determination
Value | Source | |
---|---|---|
Baseline utility value for age 60 | 0.84 | Ara and Brazier [32] |
Sexual dysfunction | 0.89 | Stewart et al. [37] |
Sexual dysfunction and urinary incontinence | 0.78 | |
Impotence and bowel dysfunction | 0.57 | |
Impotence, urinary incontinence, and bowel dysfunction | 0.45 | |
Local disease progression | 0.67 | |
Metastatic cancer | 0.25 | |
Active monitoring | 0.98 | Authors’ assumption |
Results
Description of the selected studies
Study | Country, Period, Follow-up | Effective size, Ethnicity, Age | Definition of BCR | CAPRA (N) | HR (95%CI) | C-index |
---|---|---|---|---|---|---|
Cooperberg et al., 2005 [8] | USA, 1992–2001, median = 24 m | 1439, 88% Caucasian 8.4% African-American mean = 62y (no SD) | 2 consecutive PSA ≥ 0.2 ng/mL or secondary treatment for elevated postoperative PSA | 0–1 (401) 2 (432) 3 (296) 4 (155) 5 (84) 6 (43) 7–10 (28) | 1.28 (0.79–2.08) 2.36 (1.49–3.72) 2.38 (1.40–4.03) 3.32 (1.89–5.80) 7.11 (3.84–13.15) 17.38 (9.92–30.46) | 0.660 |
Cooperberg et al., 2006 [39] | USA, 1988–2004, mean = 42 m | 1309, 59% Caucasian, mean = 61.9y (±6.6) | 1 PSA > 0.2 ng/mL or 2 consecutive PSA ≥ 0.2 ng/mL or secondary treatment for elevated postoperative PSA | 0–1 (324) 2 (329) 3 (291) 4 (158) 5 (108) 6 (76) 7–10 (60) | 1.89 (1.25–2.85) 2.75 (1.85–4.10) 3.29 (2.15–5.04) 4.51 (2.89–7.05) 7.19 (4.58–11.30) 9.90 (6.34–15.46) | 0.680 |
May et al., 2007 [42] | Germany, 1992–2005, mean = 56 m | 1296, 100% Caucasian, mean = 63.7y (±5.5) | 1 PSA > 0.2 ng/mL, 2 PSA ≥ 0.2 ng/mL or secondary treatment for elevated postoperative PSA | 0–1 (130) 2 (297) 3 (265) 4 (222) 5 (140) 6 (92) 7–10 (150) | unknown | 0.810 |
Zhao et al., 2008 [43] | USA, 1984–2006, median = 4y | 6737, 91% Caucasian, mean = 58y (no SD) | 1 PSA level > 0.2 ng/mL | 0–1 (2796) 2 (1937) 3 (1005) 4 (463) 5 (306) 6 (161) 7–10 (69) | 2.24 (1.83–2.74) 3.69 (3.01–4.54) 8.61 (6.96–10.65) 9.52 (7.57–11.97) 13.41 (10.40–17.29) 18.96 (13.87–25.92) | 0.760 |
Loeb et al., 2012 [41] | USA, 2003–2009, median = 34 m | 726, 93.5% Caucasian, mean = 59.3y (no SD) | Repeated PSA ≥ 0.2 ng/mL, secondary treatment for elevated postoperative PSA | 0–1 (441) 2 (263) 3 (113) 4 (80) 5 (57) 6 (23) 7–10 (13) | 1.1 (0.4–3.0) 4.1 (1.7–10.0) 5.1 (2.1–12.5) 10.5 (4.4–24.7) 12.2 (3.8–38.9) 47.8 (17.1–133.2) | 0.764 |
Ishizaki et al., 2011 [40] | Japan, 1999–2010, mean = 38 m | 211, 100% Japanese, mean = 62.2y (±5.8) | 2 PSA ≥ 0.2 ng/mL, secondary treatment for elevated postoperative PSA | 0–2 (85) 3–5 (106) 6–10 (20) | 2.14 (1.19–3.86) 9.14 (4.30–19.44) | 0.755 |
Budaus et al., 2012 [44] | Germany, 1992–2009, mean = 56 m | 2937, unknown, median = 64y (48–74) | 1 PSA level ≥ 0.2 ng/mL | 0–2 (1280) 3–5 (1270) 6–10 (387) | 3.1 (2.4–3.9) 7.0 (5.5–9.0) | 0.714 |
Yoshida et al., 2012 [46] | Japan, 1995–2008, median = 44 m | 503, 100% Japanese, median = 65y (47–76) | 1 PSA ≥ 0.2 ng/mL followed by a 2nd PSA higher, radiotherapy or hormonal therapy for the postoperative PSA elevation | 0–2 (138) 3–5 (257) 6–10 (108) | 1.67 (0.93–2.99) 3.97 (2.18–7.24) | 0.673 |
Seo et al., 2014 [45] | Korea, 2008–2013, median = 13 m | 115, 100% Korean, mean = 66.4y (±6.5) | 2 PSA ≥ 0.2 ng/mL, additional treatment more than 6 months after RP | unknown | unknown | 0.770 |
Association between the CAPRA score and BCR-free survival
Number of studies per subgroup | Pooled HR (High versus Low) per subgroup | p-value | Pooled HR (Intermediate versus Low) per subgroup | p-value | |
---|---|---|---|---|---|
Effective size | > 1000: 5 ≤ 1000: 4 | 14.60 [7.24–29.43] 8.13 [4.13–16.01] | 0.240 | 4.45 [2.32–8.54] 2.35 [1.59–3.47] | 0.098 |
Inclusion period | Inclusion start ≥1999: 3 Inclusion start < 1999: 6 | 10.37 [5.00–21.49] 11.78 [5.83–23.80] | 0.804 | 2.78 [1.83–4.24] 3.78 [2.04–7.00] | 0.419 |
Geographic origin | American: 4 Other: 5 | 13.37 [9.25–19.32] 9.75 [4.02–23.60] | 0.518 | 3.34 [2.41–4.61] 3.39 [1.48–7.77] | 0.971 |