Prostate cancer test improves prediction of dise...(rcent of men have metastasis. More t...),Health

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
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