Prostate Cancer: Validation of Upgrading Risk Tool

David F Jarrard, MD Vice Chair for Clinical Affairs Professor of Urology John Livesey Chair in Urologic Interview with:
David F Jarrard, MD
Vice Chair for Clinical Affairs
Professor of Urology
John Livesey Chair in Urologic Oncology What are the main findings of the study?

Dr. Jarrard: We have developed and externally validated an accurate nomogram for predicting Gleason score 6 upgrading for use in low-risk prostate cancer patients.  This nomogram incorporates only variables available at the time of diagnosis and is unique in its assessment of clinical as well as pathological factors.  Furthermore, we externally validated this study in patients with Gleason 6 prostate cancer of which 90% met the D’Amico criteria for low-risk cancer at 2 other centers (total 2000 patients).  This nomogram will aid in the decision-making process of patients diagnosed with low-risk prostate cancer. Were any of the findings unexpected?

Dr. Jarrard: The incorporation of obesity in predicting upgrading was an unexpected finding that was validated at the participating centers. What should clinicians and patients take away from your report?

Dr. Jarrard: The use of this nomogram by patients with lower risk prostate cancer provides further information that can be used in the decision to treat prostate cancer or monitor it. What recommendations do you have for future research as a result of this study?

Dr. Jarrard: The nomogram provides a basis for risk stratification.  The use of additional molecular markers may further improve the stratification of risk for prostate cancer patients.

 The nomogram is available for the public at


Development and multi-institutional validation of an upgrading risk tool for Gleason 6 prostate cancer.

Truong M, Slezak JA, Lin CP, Iremashvili V, Sado M, Razmaria AA, Leverson G, Soloway MS, Eggener SE, Abel EJ, Downs TM, Jarrard DF.

Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Cancer. 2013 Sep 4. doi: 10.1002/cncr.28303.
[Epub ahead of print]