A COMPARISON BETWEEN RISK ASSESSMENT SCORES IN PROSTATE CANCER
Abstract
Background and aim: Prostate cancer remains a prevalent cause of malignancy in men worldwide, representing the fifth leading cause of death globally. Oncologic treatment and monitoring of these patients are conducted using multiple scores that assess the risk of biochemical recurrence, with the CAPRA score and D’Amico risk stratification scheme currently being the most widely used. The study aims to compare the prognostic classification of prostate cancer patients using two different scores, identifying similarities and differences that may arise. Materials and methods: This retrospective study evaluated both the D’Amico and CAPRA scores in 54 men diagnosed with non-metastatic prostate cancer at the Regional Institute of Oncology between 2017-2021. Transrectal ultrasound-guided biopsy was performed on all patients for diagnostic purposes. The Gleason system was used to grade biopsy cores, and the 8th Edition of AJCC Cancer Staging Manual was used to evaluate clinical stage. Results: Following the evaluation of patients with CAPRA scores, out of the total of 54 patients, 12.96% (n=7) had low risk, 42.59% (n=23) had intermediate risk, and 44.44% (n=24) had high risk. Applying the D’Amico score stratified patients into the following risk groups: 5 patients (9.26%) in the low-risk group, 9 patients (16.67%) in the intermediate-risk group, and 40 patients (74.07%) in the high-risk group. In our study, we observed that after overlapping the stratification of patients with the D’Amico and CAPRA scores, out of the seven patients classified as low risk according to the D’Amico stratification, two of them were considered intermediate risk. Furthermore, D’Amico’s score considers that out of the 23 patients with intermediate scores, 69.57% (n=16) of them have a high risk. Conclusions: The D’Amico stratification tends to categorize patients into a less favorable prognostic group, necessitating a different management approach and active oncological monitoring. On the other hand, the CAPRA score, due to its multitude of composing criteria, individualizes each case, especially for patients classified in the low and intermediate risk groups, thus completing the D’Amico score. Therefore, it beneficial to utilize both scores in evaluating prostate cancer patients for an accurate prognostic assessment.
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