The CAPRA-S Score and Immune Dysfunction as a Guide to Outcome in Men Treated with Prostatectomy Radical as...

Area of Science:

• Urology
• Immunology
• Oncology

Background:

• The CAPRA-S score is a validated tool for predicting prostate cancer outcomes.
• Immune function, assessed by absolute lymphocyte count (ALC), may offer additional prognostic information.

Purpose of the Study:

• To integrate ALC into the CAPRA-S score to enhance its predictive accuracy for prostate cancer recurrence.
• To evaluate if lymphocytopenia (LCP) impacts biochemical failure-free survival (BFFS).

Main Methods:

• Clinical and pathological data were used to stratify patients into CAPRA-S risk groups.
• Post-operative ALC and PSA levels were monitored. Lymphocytopenia was defined as ALC <1,000 cells/mm³.
• Kaplan-Meier analysis was used to compare BFFS across risk groups with and without LCP.

Main Results:

• Lymphocytopenia (LCP) was more prevalent in higher CAPRA-S risk groups and significantly associated with higher PSA, Gleason, and CAPRA-S scores, and biochemical failure (BF).
• Five-year BFFS was substantially lower for patients with LCP across all CAPRA-S risk categories.
• All intermediate and high-risk patients with LCP relapsed within 6 years.

Conclusions:

• Incorporating ALC into the CAPRA-S score post-surgery improves risk stratification for prostate cancer patients.
• Declining ALC levels may serve as an early indicator of impending biochemical failure.
• Larger studies are needed to validate these findings.