The International Staging Collaboration for Prostate Cancer (STAR-CAP) has been proposed as a risk model for prostate cancer with superior prognostic power compared to the current staging system. This study aimed to evaluate the performance of STAR-CAP in predicting the risk of subsequent therapy after initial treatment and the risk of developing metastases. The study included 3425 men from an institutional observational registry with a median age of 64.9 years and a median follow-up time of 5.4 years. The primary endpoints were metastases and progression to additional therapy after initial therapy (radiation ± surgery). The risk of progression in the STAR-CAP group was estimated using a competing risk model (death). The results showed that patients with STAR-CAP stages 1A-1C had a similar risk of requiring additional therapies and developing metastasis. Compared to stage IC, each stage from 2A to 3B incrementally increased the risk of subsequent therapy (hazard ratio (HR) 1.4-5.8, respectively) and metastases (HR 1.5-10.8, respectively). The 5-year probability of receiving subsequent therapy for a patient with stage IC was 8.6%, which increased from 11.4% to 37.4% for those with stages 2A to 3B. The 5-year probability of developing metastases for patients with stage IC was 1.5%, which increased from 2.2% to 8.2% for patients with stages 2A to 3B. The probability of receiving subsequent therapy was higher for patients undergoing surgery, while radiation therapy patients were more likely to receive treatment with intensified multimodality therapies upfront.

中文翻译：

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STAR-CAP 分期系统能够预测 M0 前列腺癌初始治疗后后续治疗和转移的风险

前列腺癌国际分期协作组织 (STAR-CAP) 已被提议作为前列腺癌的风险模型，与当前的分期系统相比，其具有更好的预后能力。本研究旨在评估 STAR-CAP 在预测初始治疗后后续治疗风险和发生转移风险方面的表现。该研究纳入了来自机构观察登记的 3425 名男性，中位年龄为 64.9 岁，中位随访时间为 5.4 年。主要终点是初始治疗（放射±手术）后的转移和进展至额外治疗。使用竞争风险模型（死亡）估计 STAR-CAP 组的进展风险。结果显示，STAR-CAP 1A-1C 期患者具有相似的需要额外治疗和发生转移的风险。与IC阶段相比，从2A到3B的每个阶段逐渐增加后续治疗的风险（风险比（HR）分别为1.4-5.8）和转移风险（HR分别为1.5-10.8）。 IC 期患者接受后续治疗的 5 年概率为 8.6%，而 2A 至 3B 期患者则从 11.4% 增加至 37.4%。 IC期患者5年发生转移的概率为1.5%，2A至3B期患者的5年发生转移的概率从2.2%增加到8.2%。接受手术的患者接受后续治疗的可能性较高，而放射治疗的患者更有可能预先接受强化多学科治疗。