According to UCSF study findings, published this week, the test proved accurate in predicting bone metastasis, prostate cancer-specific mortality, and all-cause mortality when localized prostate cancer is first diagnosed. The test is known as the UCSF Cancer of the Prostate Risk Assessment, or CAPRA.
The study, involving 10,627 men, is reported in the June 9 online edition of the “Journal of the National Cancer Institute.’’
“This test should help physicians and their patients predict the likely course of the individual’s disease,” said Matthew R. Cooperberg, MD, MPH, lead investigator of the study. Cooperberg, who helped develop the risk assessment test, is a prostate cancer specialist in the UCSF Department of Urology and the UCSF Helen Diller Family Comprehensive Cancer Center.
“In this study, we looked at the CAPRA score’s ability to predict mortality across multiple forms of treatment. It should help patients and clinicians decide which tumors need to be treated, and how aggressively. We also hope that in the research setting it can serve as a well-validated and consistent means of classifying men into low, intermediate and high risk groups.”
Prostate cancer is the most common form of cancer in men and the second most common cause of cancer death after lung cancer. This year, an estimated 192,280 men will be diagnosed with the disease, and 27,360 men will die from it, according to the American Cancer Society.
While prostate cancers are ultimately lethal, most men diagnosed actually die of other causes. Because of the highly variable nature of the disease, risk assessment to calculate the chances of cancer progression takes on heightened importance when a patient is diagnosed, said Cooperberg. At the time of diagnosis, only 5 percent of men have metastasis.
More than 100 risk assessment tests have been developed in recent years, but most are unable to predict long-term outcomes and are applicable to just one form of treatment, rather than providing information relevant to multiple treatment modalities.
Because of these limitations, UCSF developed the CAPRA test. It calculates patient risk through five factors: age at diagnosis, Gleason score (a measure of how aggressive the cancer cells appear under the microscope), PSA score (prostate-specific antigen level in the blood), percentage of biopsy scores that test positive for cancer, and clinical tumor stage based on digital exam of the prostate and/or ultrasound.
“The goal of risk assessment is to find the patients at high risk of mortality and treat them aggressively, and for others to guide their treatment or surveillance plan accordingly,’’ said Cooperberg.
The CAPRA test has been independently validated in three studies as being accurate and consistent in predicting pathological and biochemical outcomes after radical prostatectomy (surgery to remove the prostate gland).
The UCSF study was intended to measure the accuracy of CAPRA for its ability to predict metastasis or mortality.
The study looked at men from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE). A national disease registry launched by UCSF in 1995, it tracks prostate cancer patients at 40 primarily community-based urology practices across the United States.
The patients in the study had undergone radical prostatectomy, radiation therapy, androgen deprivation therapy (hormone therapy), or watchful waiting.
Nearly 3 percent (311) of the men developed bone metastases, 2.4 percent (251) died of prostate cancer, and 14.9 percent (1,582) died of other causes.
The CAPRA score accurately predicted all three outcomes.
The study determined that with each point increase in CAPRA score, the risk of death from prostate cancer increases 39 percent; with each two-point increase in score, risk roughly doubles. The tool can predict risk up to 10 years.
“Given its high degree of accuracy and ease of calculation, the CAPRA score may prove an increasingly valuable tool for risk stratification in both the clinical practice and the research setting,’’ wrote the study authors.
Co-authors of the study were Jeanette M. Broering, RN, MS, MPH, director of data quality assurance in the UCSF Department of Urology, and Peter R. Carroll, MD, MPH, chair of the UCSF Department of Urology and director of strategic planning and clinical services at the UCSF Helen Diller Family Comprehensive Cancer Center.
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
Elizabeth Fernandez | EurekAlert!
Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University
The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water
In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...
The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.
Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
02.12.2016 | Medical Engineering
02.12.2016 | Agricultural and Forestry Science
02.12.2016 | Physics and Astronomy