AUA 2018: Performance Of Quantitative Gleason Grading: A Head to Head Comparison with CAPRA Score and D`Amico Groups

San Francisco, CA ( Predictive nomograms and decision tools are very important in prostate cancer to help counsel patients on the most appropriate management steps for their disease. Preoperative risk tools, in particular, can help both patients and surgeons understand oncological risks and could lead to a better understanding of the tradeoffs being made for each patient by certain treatment approaches.

The D’Amico risk classification and UCSF/CAPRA score are two of the main preoperative risk tools under widespread use. The authors of this poster note that neither of these scores specifically use quantity of aggressive Gleason pattern 4 in their nomograms. Hence, they studied the predictive abilities of Gleason 4 quantification against D’Amico and CAPRA risk tools.

2,726 prostatectomy patients were identified with necessary information from own-institutional biopsies. The primary endpoint was BCR within 5 years of prostatectomy. 14% of the patients experienced BCR in 5 years, and the C-indices for each of the tools was: D’Amico – 65.5%, CAPRA – 70.9%, and Gleason 4 quantification – 74.4%. The decision-curve analysis showed a small benefit to Gleason 4 quantification over the more common models, but CAPRA scoring was a close second.

Additional validation is needed, but this might be a useful new adjunct to use with other risk tools (such as CAPRA) to further refine our predictive knowledge during preoperative patient counseling.

Presented by: Raisa Pompe, MD; Hamburg, Germany

Written by:  Shreyas Joshi, MD, Fox Chase Cancer Center, Philadelphia, PA, @ssjoshimd at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA