Metastatic Prostate Cancer Prognosis Calculator

Prognostic Factors in Metastatic Prostate Cancer

In metastatic castration-resistant prostate cancer (mCRPC), risk stratification helps oncologists evaluate expected disease trajectories and clinical trial eligibility. Validated prognostic models, such as the Halabi and Armstrong nomograms derived from phase III trial data, use clinical and laboratory metrics to categorize patients into low, intermediate, and high-risk groups.

The 7 Key Prognostic Factors

• ECOG Performance Status: Performance status ≥ 2 reflects functional impairment and carries adverse prognostic weight.
• Visceral Metastases: Presence of metastases in organs such as the liver or lungs (versus bone/lymph nodes only) indicates more aggressive disease.
• Opioid Analgesic Use: Regular use of strong opioid analgesics for cancer-related bone or visceral pain.
• Hemoglobin Level: Anemia (hemoglobin < 12 g/dL) correlates with systemic inflammatory response and bone marrow dysfunction.
• Alkaline Phosphatase (ALP): Elevated ALP (≥ 1.5× upper limit of normal) reflects high bone turnover and skeletal tumor burden.
• Lactate Dehydrogenase (LDH): LDH levels above upper limit of normal indicate tumor burden and cell turnover.
• Prostate-Specific Antigen (PSA): Baseline PSA ≥ 50 ng/mL signifies high overall disease volume.