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Clinical calculator summary

Prostate Cancer Risk Stratification (NCCN & CAPRA)

This master calculator integrates three essential tools for localized prostate cancer decision-making: 1.

Evidence-based context for fast calculator use

Purpose:
Unified assessment using NCCN Guidelines (v4.2024), CAPRA Score, and Epstein Criteria.
Population:
patients whose clinical question requires the component models displayed in the combined panel
Factors:
Age, PSA, Prostate Volume, Clinical T-Stage, Primary Gleason Pattern, Secondary Gleason Pattern, Number of Positive Cores, Total Cores Taken
Reference:
Cooperberg MR, Pasta DJ, Elkin EP, et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol. 2005;173(6):1938-1942.
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Prostate Cancer Risk Stratification (NCCN & CAPRA)

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Clinical Context & Background

This master calculator integrates three essential tools for localized prostate cancer decision-making:
1. NCCN Risk Stratification (v4.2024)
The standard of care for assigning risk groups. It guides the choice between Active Surveillance, Surgery, or Radiation (+/- ADT).
Key Inputs: T-Stage, PSA, Grade Group, Biopsy Core stats.
2. CAPRA Score (UCSF)
A validated 0-10 point score that predicts biochemical recurrence-free survival (RFS) after radical prostatectomy. It provides a granular risk assessment often used to refine NCCN grouping.
Formula: Age + PSA + Gleason + T-Stage + % Positive Cores.
3. Epstein Criteria
Historical criteria used to identify "clinically insignificant" cancers (very low volume/grade) that are ideal candidates for Active Surveillance.
Primary Source EvidenceCooperberg MR, Pasta DJ, Elkin EP, et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol. 2005;173(6):1938-1942.
Formula Logic
Panel Logic: 1. NCCN: Hierarchical categorization (Very Low -> Very High). 2. CAPRA: Sum of weighted points (0-10). 3. Epstein: Binary check (Pass/Fail) for AS eligibility.

Reference Data

System / CategoryCriteria / ScoreManagement / Prognosis
NCCN: Very LowT1c, GG1, PSA<10, <3 cores, PSAD<0.15Active Surveillance
NCCN: LowT1-T2a, GG1, PSA<10Active Surveillance
NCCN: Favorable Int1 IF, GG1-2, <50% coresActive Surv / Brachy / RP
NCCN: Unfav Int2+ IFs OR GG3 OR >50% coresRP or EBRT + ADT (4-6mo)
NCCN: HighT3a OR GG4-5 OR PSA>20EBRT + ADT (1.5-3y) or RP
NCCN: Very HighT3b-T4 OR Primary Gleason 5Intensified Multimodal Tx
---------
CAPRA: Low RiskScore 0 - 2High 5y RFS (~91%)
CAPRA: IntermediateScore 3 - 5Intermediate 5y RFS (~74%)
CAPRA: High RiskScore 6 - 10Lower 5y RFS (~56%)
---------
Epstein: InsignificantPSAD<0.15, GG1, <3 cores, <50% invStrong candidate for AS
Epstein: SignificantFails any criteriaMay require treatment

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

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

When To Use

  • Use Prostate Cancer Risk Stratification (NCCN & CAPRA) when unified assessment using NCCN Guidelines (v4.2024), CAPRA Score, and Epstein Criteria.
  • 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 NCCN: Very Low through Epstein: Significant.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Review every component result separately; if models disagree, verify inputs and follow the more cautious disease-specific pathway rather than averaging scores.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • A panel improves comparison but does not make component models interchangeable or create a new validated composite score.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients whose clinical question requires the component models displayed in the combined panel

How to apply this result

For a representative case, verify Age, PSA, Prostate Volume, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

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Frequently Asked Questions

When should Prostate Cancer Risk Stratification (NCCN & CAPRA) be used?

Use it for patients whose clinical question requires the component models displayed in the combined panel when all required inputs and the intended clinical setting are confirmed.

Can Prostate Cancer Risk Stratification (NCCN & CAPRA) 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.