The Cancer Prognostics and Health Outcomes Unit of the University of Montreal, directed by Dr. Pierre Karakiewicz, in collaboration with several centers of excellence from around the world has developed a series of computerized devices to help patients and their physicians decide among the major treatment choices for several cancers and non-malignant conditions. The available applications, developed by Pierre Karakiewicz et al., can be used in prostate, bladder, kidney, adrenal and penile cancers, as well as in renal transplantation. Click here to access nomograms.

Prostate Cancer

Here is a list of available Prostate Cancer nomograms:

Before Diagnosis: Available nomograms for prediction of prostate cancer prior to diagnosis

• Biopsy with PSA 0-2.5 ng/ml - To predict the probability of prostate cancer at biopsy in men with PSA values less than or equal to 2.5 ng/ml.
• Initial Extended Biopsy - To predict the probability of prostate cancer at initial extended (10 or more cores) biopsy of the prostate.
• Extended Repeat Biopsy - To predict the probability of prostate cancer at repeat extended (10 or more cores) biopsy of the prostate.
• Saturation Biopsy - To predict the probability of prostate cancer at saturation (24 cores) biopsy,
• 120 day mortality after biopsy - To predict the probability of all-cause mortality at 120 days after prostaticbiopsy.
• Initial Sextant Biopsy - To predict the probability of prostate cancer at initial sextant biopsy of theprostate.
• PSA doubling time - PSA doubling time, velocity and slope calculator.

Before Treatment I - Nomograms predicting prostate cancer stage and grade at treatment

• Gleason upgrade Bx. vs. RP - To predict the probability of Gleason sum upgrading (having a more aggressive prostate cancer grade at radical prostatectomy than at prostate biopsy).
• Extra capsular extension - To predict the probability of prostate cancer spread beyond the capsule of the prostate.
• Seminal vesicle invasion - To predict the probability of prostate cancer invasion into the seminal vesicles.
• Lymph node invasion - nomograms predicting the probability of lymph node invasion (LNI).
• PSA doubling time - PSA doubling time, velocity and slope calculator.

Before Treatment II - Nomograms predicting prostate cancer characteristics, as well as mortality and survival after radical prostatectomy

• Insignificant PCa - Probability of having a clinically insignificant prostate cancer (small volume, favorable grade,organ confined cancer) at radical prostatectomy and nomograms predicting the probability of having clinically meaningful prostate cancer (prostate cancer volume in excess of 0.5cc).
• Transition zone PCa - Probability of predominant transition zone prostate cancer at radical prostatectomy. Prostate cancer (PCaS) situated within the transition zone (TZ) are more favorable than the usual prostate cancer (PCaS) situated in the peripheral zone, despite having more elated serum PSA values.
• 30-day mortality after RP - Probability of mortality within 30 days of radical prostatectomy.
• 10+ year survival - Probability of 10 year survival after either radical prostatectomy or radiotherapy provided no prostate cancer relapse.
• PSA doubling time - PSA doubling time, velocity and slope calculator.

After Surgery - Nomograms predicting prostate cancer recurrence and prostate cancer-specific survival after radical prostatectomy

• PSA recurrence - PSA recurrence after radical prostatectomy.
• Local recurrence - Probability of long-term (20 years)local recurrence after radical prostatectomy.
• Distant recurrence - Probability of distant recurrence (metastases) within 20 years after radical prostatectomy.
• PCa-specific mortality - Probability of prostate cancer-specific mortality within 20 years after radical prostatectomy.
• PSA doubling time - PSA doubling time, velocity and slope calculator.

After PSA Relapse - Available nomograms for prediction of survival and distant metastases after PSA recurrence

• Metastatic progression - Probability of distant metastases after PSA recurrence in men treated with radical prostatectomy.
• HT vs. PCa mortality - Probability of death from PCa in men treated with radical prostatectomy and subsequent hormonal therapy (HT) for PCa relapse. Relapses may be biochemical (elevated PSA), local (local prostate cancer recurrence) or distant (metastatic disease).
• PCa death after PSA relapse - Probability of prostate cancer-specific mortality after PSA recurrence in men treated with radical prostatectomy.
• PSA doubling time - PSA doubling time, velocity and slope calculator.

Hormone failure - Available nomograms for prediction of prostate cancer-specific survival after failure of hormonal therapy

• Survival hormone refractory PCa - To predict the probability of prostate cancer-specific mortality in men with androgen insensitive prostate cancer.
• PSA doubling time - PSA doubling time, velocity and slope calculator.

Click here to access nomograms.