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!
Nanoparticles as a Solution against Antibiotic Resistance?
15.12.2017 | Friedrich-Schiller-Universität Jena
Plasmonic biosensors enable development of new easy-to-use health tests
14.12.2017 | Aalto University
DNA molecules that follow specific instructions could offer more precise molecular control of synthetic chemical systems, a discovery that opens the door for engineers to create molecular machines with new and complex behaviors.
Researchers have created chemical amplifiers and a chemical oscillator using a systematic method that has the potential to embed sophisticated circuit...
MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.
Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...
Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...
Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.
To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...
The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.
Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...
11.12.2017 | Event News
08.12.2017 | Event News
07.12.2017 | Event News
15.12.2017 | Power and Electrical Engineering
15.12.2017 | Materials Sciences
15.12.2017 | Life Sciences