GUROCGenito-Urinary Radiation Oncologists of Canada
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An additional goal of this work was to validate the GUROC ProCaRS nomograms for LDR-brachytherapy only and for EBRT only in a single-institution database.
The GUROC ProCaRS database is a retrospective, multi-institutional database containing data from 7974 patients with localized prostate cancer.
The GUROC system groups patients into three risk categories: low (T1-T2a and PSA [less than or equal to]10 ng/mL and Gleason [less than or equal to]6); intermediate (T1-T2 and PSA [less than or equal to]20 ng/mL and Gleason [less than or equal to]7 and not otherwise low-risk); and high (T3-T4 or PSA >20 ng/mL or Gleason 8-10).
The ProCaRS (ProCaRS-5) system groups patients into five risk categories according to the GUROC system: low (T1-T2a and PSA [less than or equal to]10 ng/mL and Gleason [less than or equal to]6); low-intermediate (T1-T2 and PSA [less than or equal to]20 ng/ml and PSA [less than or equal to]10 ng/mL or [PSA >10 ng/mL and T1-T2a or Gleason [less than or equal to]6]); high-intermediate (T1-T2 and PSA [less than or equal to]20 ng/mL and [PSA >10 ng/mL and T2b/c or Gleason 7]); high (T3-T4 or [PSA >20 ng/mL and PSA <30 ng/mL or Gleason 8-10] and positive core percentage <87.5%); and very high ([T3-T4 or Gleason 8-10 or PSA >20 ng/mL] and [PSA [greater than or equal to]30 ng/mL or positive core percentage [greater than or equal to]87.5%]).(11)
The concordance index (C-index) was calculated and reported from Cox proportional hazards regression for BFFS using 10-fold cross-validation for all possible risk-stratification variables, as described previously (CAPRA score, CAPRA-5, CAPRA-3, ProCaRS, GUROC, and NCCN).
However, C-index identified CAPRA score and ProCaRS as superior to the historical GUROC and NCCN risk-stratification systems for both databases.
We found that the CAPRA score and ProCaRS were superior to the GUROC and NCCN risk-assessment models for predicting BFFS in both cohorts.
The GUROC will undertake a project to create a multi-institutional database to delineate the appropriate definitions of low-intermediate, high-intermediate and high-risk prostate cancer within a five-group risk stratification system.