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Clinical calculator summary

Epstein Criteria (Insignificant Cancer)

The Epstein Criteria are used to identify patients with "clinically insignificant" prostate cancer who are ideal candidates for Active Surveillance.

Evidence-based context for fast calculator use

Purpose:
Epstein Criteria evaluate PSA density, Gleason score, and core data to identify clinically insignificant prostate cancer for active surveillance.
Population:
patients undergoing prostate cancer diagnostic, pathologic, recurrence, or molecular-risk assessment
Factors:
Gleason Score, Number of Positive Cores, % Cancer Involvement in any single core, PSA Density
Reference:
Epstein JI, Walsh PC, Carmichael M, Brendler CB. Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA. 1994;271(5):368-374.
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Epstein Criteria (Insignificant Cancer)

Clinical Context & Background

The Epstein Criteria are used to identify patients with "clinically insignificant" prostate cancer who are ideal candidates for Active Surveillance. It relies on PSA density, number of positive biopsy cores, and percentage of cancer involvement per core.
Primary Source EvidenceEpstein JI, Walsh PC, Carmichael M, Brendler CB. Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA. 1994;271(5):368-374.
Formula Logic
Insignificant if: PSAD < 0.15, Gleason ≤ 6, < 3 positive cores, ≤ 50% cancer in any core.

Reference Data

CriteriaResult
Met All CriteriaClinically Insignificant (Candidate for AS)
Failed Any CriteriaClinically Significant (Treatment likely needed)

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use Epstein Criteria (Insignificant Cancer) when epstein Criteria evaluate PSA density, Gleason score, and core data to identify clinically insignificant prostate cancer for active surveillance.
  • Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.

How To Interpret

  • Interpret the displayed result using the calculator-specific formula and reference table, spanning Met All Criteria through Failed Any Criteria.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Confirm biopsy versus prostatectomy setting, PSA timing, grade group, clinical/pathologic stage, imaging, life expectancy, and treatment history.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • Diagnostic, post-prostatectomy, genomic, and recurrence tools must be used only at their intended decision point.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients undergoing prostate cancer diagnostic, pathologic, recurrence, or molecular-risk assessment

How to apply this result

For a representative case, verify Gleason Score, Number of Positive Cores, % Cancer Involvement in any single core, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

Prostate Cancer hubContinue to related calculators and clinical workflow resources.

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Frequently Asked Questions

When should Epstein Criteria (Insignificant Cancer) be used?

Use it for patients undergoing prostate cancer diagnostic, pathologic, recurrence, or molecular-risk assessment when all required inputs and the intended clinical setting are confirmed.

Can Epstein Criteria (Insignificant Cancer) determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.