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. 2020 Dec;9(24):9346-9352.
doi: 10.1002/cam4.3548. Epub 2020 Oct 24.

Modified J-CAPRA scoring system in predicting treatment outcomes of metastatic prostate cancer patients undergoing androgen deprivation therapy

Jasmine Lim  1 , Shiro Hinotsu  2 , Mizuki Onozawa  3 , Rohan Malek  4 , Murali Sundram  5 , Guan C Teh  6 , Teng-Aik Ong  1 , Shankaran Thevarajah  7 , Rohana Zainal  8 , Say C Khoo  9 , Shamsuddin Omar  10 , Noor A Nasuha  11 , Hideyuki Akaza  12
Affiliations

Modified J-CAPRA scoring system in predicting treatment outcomes of metastatic prostate cancer patients undergoing androgen deprivation therapy

Jasmine Lim et al. Cancer Med. 2020 Dec.

Abstract

The J-CAPRA score is an assessment tool which stratifies risk and predicts outcome of primary androgen deprivation therapy (ADT) using prostate-specific antigen, Gleason score, and clinical TNM staging. Here, we aimed to assess the generalisability of this tool in multi-ethnic Asians. Performance of J-CAPRA was evaluated in 782 Malaysian and 16,946 Japanese patients undergoing ADT from the Malaysian Study Group of Prostate Cancer (M-CaP) and Japan Study Group of Prostate Cancer (J-CaP) databases, respectively. Using the original J-CAPRA, 69.6% metastatic (M1) cases without T and/or N staging were stratified as intermediate-risk disease in the M-CaP database. To address this, we first omitted clinical T and N stage variables, and calculated the score on a 0-8 scale in the modified J-CAPRA scoring system for M1 patients. Notably, treatment decisions of M1 cases were not directly affected by both T and N staging. The J-CAPRA score threshold was adjusted for intermediate (modified J-CAPRA score 3-5) and high-risk (modified J-CAPRA score ≥6) groups in M1 patients. Using J-CaP database, validation analysis showed that overall survival, prostate cancer-specific survival, and progression-free survival of modified intermediate and high-risk groups were comparable to those of original J-CAPRA (p > 0.05) with Cohen's coefficient of 0.65. Around 88% M1 cases from M-CaP database were reclassified into high-risk category. Modified J-CAPRA scoring system is instrumental in risk assessment and treatment outcome prediction for M1 patients without T and/or N staging.

Keywords: advanced prostate cancer; overall survival; progression-free survival; risk stratification; treatment response.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Distribution of J‐CAPRA score in the M‐CaP and J‐CaP databases
FIGURE 2
FIGURE 2
The (A) overall survival, (B) prostate cancer‐specific survival, and (C) progression‐free survival for original J‐CAPRA intermediate‐risk group, IRG (3–7) and high‐risk group, HRG (≥8) and modified J‐CAPRA intermediate (3–5) and high‐risk (≥6) groups among metastatic (M1) prostate cancer patients
See this image and copyright information in PMC

References

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