Update of the MSKCC nomogram for metastatic progression and its role in active surveillance: the Italian TPCP cohort - Summary - MDSpire

Update of the MSKCC nomogram for metastatic progression and its role in active surveillance: the Italian TPCP cohort

  • By

  • Nicolas Destefanis

  • Daniela Zugna

  • Valentina Fiano

  • Renata Zelic

  • Michelangelo Fiorentino

  • Francesca Giunchi

  • Piero Fariselli

  • Mauro Giulio Papotti

  • Paola Cassoni

  • Marco Oderda

  • Paolo Gontero

  • Luca Lianas

  • Mauro Del Rio

  • Giuseppe Carlo Iorio

  • Umberto Ricardi

  • Olof Akre

  • Andreas Pettersson

  • Lorenzo Richiardi

  • May 13, 2026

  • 0 min

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Objective:

To update and compare prognostic models for predicting metastatic progression in prostate cancer and evaluate the impact of nomogram-based risk thresholds on active surveillance eligibility, emphasizing their clinical significance.

Key Findings:
  • The MSKCC nomogram outperformed CAPRA and D’Amico models in predicting metastatic progression and overall mortality, with specific metrics indicating statistical significance.
  • Using the 95th percentile of MSKCC's predicted probabilities increased active surveillance eligibility from 7.8% to 57.0% without significantly raising metastatic risk, with observed 5-year risk at 1.7%.
Interpretation:

The MSKCC nomogram provides a more accurate prediction of metastatic progression, which could enhance patient selection for active surveillance and improve shared decision-making by providing clearer risk stratification.

Limitations:
  • The study is based on a single cohort from Italy, which may limit generalizability to other populations.
  • Potential biases in patient selection and follow-up data may affect outcomes, warranting caution in interpretation.
Conclusion:

Implementing the MSKCC nomogram for risk assessment could optimize active surveillance strategies in prostate cancer management.

Original Source(s)

Update of the MSKCC nomogram for metastatic progression and its role in active surveillance: the Italian TPCP cohort

  • by Nicolas Destefanis, Daniela Zugna, Valentina Fiano, Renata Zelic, Michelangelo Fiorentino, Francesca Giunchi, Piero Fariselli, Mauro Giulio Papotti, Paola Cassoni, Marco Oderda, Paolo Gontero, Luca Lianas, Mauro Del Rio, Giuseppe Carlo Iorio, Umberto Ricardi, Olof Akre, Andreas Pettersson, Lorenzo Richiardi

  • May 13, 2026

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