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.
Cancer medicine. 2020 Oct 24 [Epub ahead of print]
Jasmine Lim, Shiro Hinotsu, Mizuki Onozawa, Rohan Malek, Murali Sundram, Guan C Teh, Teng-Aik Ong, Shankaran Thevarajah, Rohana Zainal, Say C Khoo, Shamsuddin Omar, Noor A Nasuha, Hideyuki Akaza
Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Department of Biostatistics and Clinical Epidemiology, Sapporo Medical University, Hokkaido, Japan., Department of Urology, School of Medicine, International University of Health and Welfare, Chiba, Japan., Department of Urology, Selayang Hospital, Ministry of Health Malaysia, Selangor, Malaysia., Department of Urology, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia., Department of Urology, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia., Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Malaysia., Department of Surgery, Sultanah Bahiyah Hospital, Ministry of Health Malaysia, Alor Setar, Malaysia., Department of Urology, Penang Hospital, Ministry of Health Malaysia, Penang, Malaysia., Department of Urology, Sultanah Aminah Hospital, Ministry of Health Malaysia, Johor Bahru, Malaysia., Department of Surgery, Raja Perempuan Zainab II Hospital, Ministry of Health Malaysia, Kota Bahru, Malaysia., Strategic Investigation on Comprehensive Cancer Network, Interfaculty Initiative in Information Studies/Graduate School of Interdisciplinary Information, University of Tokyo, Tokyo, Japan.