ToolsCalculators
UCSF-CAPRA Score for Prostate Cancer Risk
Preoperative risk of recurrence after treatment for localized prostate cancer.
UCSF-CAPRA Score for Prostate Cancer Risk
PSA at diagnosis
ng/mL
Biopsy Gleason pattern
Clinical T stage
Age at diagnosis
Percent of biopsy cores positive
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When to use
- Estimating risk of biochemical recurrence, metastasis, and prostate-cancer-specific mortality at diagnosis, before choice of primary treatment.
- Comparing risk across treatment modalities (surgery, radiation, active surveillance, ADT) using a single validated preoperative score.
Formula
CAPRA = PSA points (<=6=0, 6.1-10=1, 10.1-20=2, 20.1-30=3, >30=4) + Gleason points (no pattern 4/5=0, secondary pattern 4/5=1, primary pattern 4/5=3) + clinical T stage (T1c-T2a=0, T2b-T3a=1) + age (<50=0, >=50=1) + percent positive biopsy cores (<34%=0, >=34%=1). Range 0-10.
Pearls and pitfalls
- Validated for recurrence, metastasis, and mortality across surgical and non-surgical primary treatments, including primary androgen-deprivation cohorts.
- Concordance index in the original derivation was modest (~0.66); use alongside other clinical judgment and updated nomograms.
References
- Cooperberg MR, Pasta DJ, Elkin EP, et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol. 2005;173(6):1938-1942.
- Cooperberg MR, Broering JM, Carroll PR. Risk assessment for prostate cancer metastasis and mortality at the time of diagnosis. J Natl Cancer Inst. 2009;101(12):878-887.