Prostate Cancer: Prediction Tools

Our prostate cancer nomograms are online prediction tools that can be used to decide which treatment approaches will result in the greatest benefit for men at various stages of prostate cancer. Doctors at Memorial Sloan Kettering have created four nomograms that are customized for men at different stages of prostate cancer treatment:

We have also created additional tools for measuring PSA doubling time and tumor volume.

These nomograms were designed to be used by physicians and by men diagnosed with prostate cancer. If you are a patient, we recommend that you use these tools in consultation with your doctor or healthcare provider. You should speak with your physician before making any treatment decisions.

Pre-Treatment

Our pre-treatment nomogram can be used to predict the probability of cancer remaining progression-free following radical prostatectomy or brachytherapy.

You will need the following information to use the nomogram:

  • Most recent PSA (prostate-specific antigen) value
  • Primary and secondary Gleason grade
  • Doctor’s assessment of patient’s clinical tumor stage (using the 1992 or 1997 UICC system)
  • Number of positive cores (samples) found during biopsy
  • Number of negative cores (samples) found during biopsy
  • Planned radiation therapy dose if patient has already seen a radiation oncologist
  • Whether patient has had neoadjuvant hormones
  • Whether patient has had neoadjuvant radiation

If you are a patient, print the Pre-Treatment Worksheet and bring it with you to your next appointment. The worksheet contains a list of what you need to use this prediction tool.

Post-Radical Prostatectomy

Our post-radical prostatectomy nomogram can be used to predict the probability that a patient's cancer will recur after radical prostatectomy; that is, the probability at two, five, seven, and ten years that the patient's serum PSA level will become detectable and begin to rise steadily. This prediction tool should only be used for patients when radical prostatectomy has been the sole, primary treatment.

You will need the following information in order to use the nomogram:

  • Patient’s PSA (prostate-specific antigen) value prior to surgery or other treatment
  • Primary Gleason grade at surgery
  • Secondary Gleason grade at surgery
  • Year of prostatectomy
  • Number of months the patient has been disease-free
  • Whether surgical margins were positive
  • Whether cancer was found in the seminal vesicles
  • Whether cancer was found in the lymph nodes (if any were removed)
  • Whether there was extracapsular extension
  • Whether the patient has received neoadjuvant hormones
  • Whether the patient has had neoadjuvant radiation

Salvage Radiation Therapy

Our salvage radiation therapy nomogram is designed for men who have experienced a recurrence of their prostate cancer after treatment with radical prostatectomy. The tool predicts the probability the recurrence can be successfully treated with salvage radiation therapy (SRT), calculating the probability that the cancer will be controlled and the PSA will be undetectable six years after SRT.

You will need the following information in order to use the nomogram:

  • Number of months patient was disease-free
  • Primary Gleason grade at surgery
  • Secondary Gleason grade at surgery
  • Pre-radiotherapy PSA
  • PSA at time of prostatectomy
  • PSA doubling time
  • Radiation dose (if applicable)
  • Whether surgical margins were positive
  • Whether there was seminal vesicle involvement
  • Whether there was lymph node involvement
  • Whether there was extra capsular extension
  • Whether neoadjuvant hormones were received
  • Whether the patient had an elevated postradical prostatectomy PSA

If you are a patient, print our Salvage Radiation Therapy Worksheet and bring it with you to your next appointment.

Hormone Refractory

Our hormone refractory nomogram can be used by patients with advanced, metastatic prostate cancer, who have a rising PSA and evidence of progression of their cancer despite maximal treatment with hormone therapy. (Cancer at this stage is also called “hormone refractory.”) The nomogram can be used to predict the probability of survival one and two years later based on a man's age, his PSA level, his performance status, and a variety of standard laboratory tests.

If you are considering receiving hormone refractory treatment, you will need to know the following information to complete this nomogram:

  • Karnofsky Performance Status (KPS)
  • Hemoglobin (HGB) value
  • PSA
  • Lactate dehydrogenase (LDH) value
  • Alkaline phosphatase (ALK) value
  • Albumin value

If you are a patient, print the Hormone Refractory Worksheet and bring it with you to your next appointment.

Additional Tools

We have also developed a set of statistical devices for measuring PSA doubling time and tumor volume. These are not required to complete the nomograms above.

PSA Doubling Time

Our PSA doubling time tool can be used to calculate the rate of rise of PSA, expressed as the velocity in nanograms/ml/year, or the PSA doubling time, in months or years. To use this tool, you will need to know the following information:

  • At least two PSA test results
  • Date the tests were taken

Prostate Volume

Our prostate volume tool calculates prostate volume, which is used to interpret PSA results. To use this tool, you will need to know the following information:

  • Prostate length
  • Width/transverse
  • Prostate height
  • Pretreatment PSA

Contact Us

If you have questions or comments, please contact us at publicaffairs@mskcc.org.

Use our prostate cancer nomograms.