Predictive models and prostate cancer

Prostate cancer stage migration has changed the diagnostic approach toward men at risk of the disease. For example, sextant needle biopsy of the prostate has been abandoned in favor of biopsies using 10 or more cores. This has in turn affected the stage and grade of newly diagnosed prostate cancers, with a shift toward earlier stage and lower grade. In this manuscript we review novel diagnostic, staging, and preoperative prognostic nomograms that have been developed to accommodate the stage migration. Several novel nomograms have been developed for the purpose of prediction of initial and repeat-biopsy outcomes using 10 or more biopsy cores. Additionally, a novel saturation biopsy nomogram has also been devised. For the purpose of staging, the Partin tables have recently been updated. A series of contemporary nomograms have also been developed to predict extracapsular extension, seminal vesicle invasion, and lymph node invasion. The preoperative nomogram for prediction of biochemical recurrence, introduced by Kattan and colleagues, has been updated and predicts up to 10 years after radical prostatectomy.