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For physicians and residents. Educational decision support based on published evidence and recommendations. It does not establish a diagnosis or treatment plan and does not replace specialist or multidisciplinary judgement. Privacy: case data are processed locally in this browser and are not transmitted to, stored by, or accessible to carcinologica.com. Ordinary website technical data such as server logs or cookie-consent data are processed separately.

Prostate Cancer Evidence Navigator

Case-based classification, reasoning and evidence — release candidate v1.1.0

🔒 Case stays on this device No server-side case storage v1.1.0 · Candidate
How to use1 Enter the core case · 2 Resolve blocking or safety items · 3 Review the case interpretation · 4 Save, print or hand off.
Practice context European evidence core + transparent national overlay
European core: EAU 2026 clinical recommendations + EMA regulatory product information. Select a country to add its national layer.
Input mode
Country comparator: the report shows the same case across all twelve contexts, but only labels a treatment difference when a deterministic national rule is encoded. “Not computed” never means agreement. No clinical case is uploaded by this function.

Disease course

1
Treatment history is separate from recurrence and metastatic status. A patient can simultaneously be after prostatectomy, have biochemical recurrence, and later develop metastatic disease.
Surgery date or RT/brachy/focal-treatment completion date. Used for recurrence-interval teaching.

Androgen-deprivation status

2

Advanced & systemic context

2b
Treatment sequencing matters in advanced prostate cancer. The same medicine can be appropriate, weakly supported, redundant, or inappropriate depending on what the patient has already received.
Molecular-testing prompts appear when the entered disease state makes them relevant.
EAU recommends early somatic HRR/MMR testing in metastatic disease and germline testing at least for BRCA1/2, ATM and MMR in high-risk localized disease, particularly in metastatic disease. A molecular result is not interchangeable with drug authorization or reimbursement.
This is not the same as a staging PSMA PET being merely “positive”. Radioligand selection uses dedicated uptake/distribution criteria.

Patient

3
Charlson measures comorbidity burden affecting competing mortality; it is not a performance-status scale. This published prognosis model specifically uses Charlson comorbidity (0 vs ≥1), so WHO/ECOG or Karnofsky cannot be substituted into the equation.
The published competing-risk model simplifies Charlson comorbidity to 0 versus ≥1. This is deliberately separate from the more granular PCCI longevity cross-check below.
PCCI longevity calculator — optional cross-check
Prostate Cancer Comorbidity Index
Age-adjusted weighted comorbidity score. Prostate cancer itself is not counted.
Calculated PCCI: —
Enter age above; the score will update automatically. The 2026 longevity estimates come from large US VA and SEER-Medicare cohorts and are a cross-check, not a France-calibrated life table.
In this PCCI weighting, some common diagnoses such as uncomplicated hypertension or uncomplicated diabetes do not carry a positive score. That does not make them clinically irrelevant; it only reflects this model's mortality weighting.

PSA & pathology

4
In the AFU D'Amico table, PSA ≤10 may satisfy the low-risk PSA criterion; >10 to 20 is intermediate; >20 is high-risk.
— ng/mL/mL
AFU discusses PSA-density bands <0.10, 0.10–0.15, 0.15–0.20 and >0.20 in MRI/biopsy decision data. A threshold is not a biological cliff.
Longitudinal PSA & kinetics optional; useful in recurrence
Enter dated PSA values. PSADT is log-linear over all valid positive values; assay noise, testosterone recovery and PSA bounce still require clinical interpretation.
PSADT—
Series span—
Recurrence timing—
Enter at least two dated positive PSA values.
+
ISUP Grade Group: —
The interface asks for the pathology observation and derives ISUP automatically. This avoids asking the user to enter both Gleason and ISUP and creating internal contradictions.
—

Local & metastatic staging

5
Select a cT category to see its definition.
For the D'Amico implementation here, ≤T2a satisfies the low T-stage criterion, T2b is intermediate, and ≥T2c triggers high risk. The eventual staging module will separately explain the anatomical basis of each T category.
Select nodal status to see its definition.
Select metastatic status to see its definition.
The final version will distinguish imaging modality and imaging-based stage explicitly. It should not silently overwrite a clinician-entered cTNM category.

Baseline function

6
These baseline variables will later anchor PROM comparisons between EBRT fractionations and HDR brachytherapy. Trial averages must be shown separately from individualized predictions unless a validated prediction model exists.

Safety, supportive care & follow-up

6b
Case-specific surveillance / follow-up
What to check, how often, and which tests should be triggered rather than ordered routinely.
Waiting for case
Complete disease state and treatment status.
Intervals are shown only where the cited guideline/product information states them. “Regular imaging” is not converted into an invented fixed scan interval.
ADT-specific safety prompts will appear when hormonal treatment is entered.
EAU recommends structured monitoring during ADT, including testosterone, renal/liver/metabolic parameters and bone health. Combination therapy increases fracture and toxicity burden; the exact medicine-specific schedule should always be taken from the current product information.
EAU follow-up EAU quality of life / supportive care EMA Xgeva EMA Zometa

Management

v1.0-rc7
Treatment applicability — alpha
Activated only for newly diagnosed cN0M0 disease with a complete risk classification. “Evidence-supported” means a reasonable published option for the entered disease state; it is not a treatment recommendation.
Waiting for complete case
Complete PSA, Gleason/ISUP, cT, N and M to activate treatment applicability.
Guideline concordance & provenance
Source-specific positions are kept separate. “Agreement” means the encoded propositions point in the same clinical direction; it is not a new synthetic guideline grade.
Waiting for case
Complete the disease state to compare the encoded AFU, EAU and SFRO/RecoRad positions.
Rule/source audit trail
Triggered rule provenance appears here.
Systemic therapy & prescription reference
Case-state relevance + direct regulatory/local references. This is a prescribing pre-check, not a medication order.
Waiting for case
Before starting or renewing an anticancer medicine, always verify current SmPC/local monograph information, the exact indication, prior therapies, required companion treatment, contraindications/interactions, monitoring and local prescribing/reimbursement restrictions. “Relevant” below is not sufficient on its own to prescribe or renew.
Select a current medicine to run a renewal-oriented disease-state pre-check.
Select a medicine to show baseline tests, scheduled monitoring, major toxicities and supportive-care reminders.
EMA medicines National drug source Select a national context for local product information.
Complete N/M status and hormonal state to obtain case-relevant systemic-therapy context.
Ready to prescribe radiotherapy?Carry the reviewed case into the local protocol workflow; re-enter and verify the final prescription in the authorised system.Open RT Prescription Navigator →
Prescription draft / patient note
Workflow rule: open the current SmPC/local drug source first. The Navigator deliberately does not supply a static dose. Enter only what you have just verified, then transfer/sign the final prescription in the authorised local prescribing system.
Select a current medicine and complete the verification steps before generating a draft.
No draft generated.
Individualized prognosis — competing-risk model
Independent educational implementation of the published 2019 Thurtle et al. model equations. It compares conservative management with immediate radical treatment in newly diagnosed non-metastatic disease. It is not the current Cambridge Predict Prostate web tool and does not reproduce its later BRCA/continuous-biopsy updates.
Waiting for inputs
Enter age, PSA, Gleason/ISUP, cT, N/M status and Charlson comorbidity (0 vs ≥1) to activate the model.
Model scope, uncertainty and derivation
The original model was developed from observational registry data and externally validated internationally. The radical-treatment coefficient combined prostatectomy and radical radiotherapy because no adequate randomized evidence showed a survival difference between them. The published treatment effect was HR ≈0.50 (95% CI 0.38–0.67); the Navigator shows a sensitivity range using that treatment-effect interval only. This is not a full prediction interval.
The model is intended for newly diagnosed non-metastatic patients before treatment, particularly where both conservative and radical management are plausible. It is less well tested at very high PSA, very high grade and advanced local stage. The current implementation uses the original published base equations and omits the later BRCA/continuous-biopsy extension.
“Restricted mean survival over 15 years” is derived mathematically from the published annual survival curve and is shown as a bounded 15-year summary, not as total lifetime expectancy.
Comparative outcomes — evidence lens
Study-level evidence relevant to the entered case. These are cohort/trial results, not individualized predictions. Numbers are kept inside their original comparison so that unlike populations and follow-up times are not mixed.
Waiting for complete case
Complete a newly diagnosed cN0M0 case to show relevant comparative evidence.
Clinical-trial navigator
Local first. Search links are seeded by disease state; they do not establish eligibility or guarantee an open slot.
Manual screening
ICM MontpellierCurrent ICM clinical-trial directory EU / EEA CTISOfficial European clinical-trial portal EU trial mapCountry, status and trial-site exploration InternationalClinicalTrials.gov seeded search
Complete the disease-course fields to seed a more specific search.
Prototype architecture principle: the browser records observations; derived values, staging checks and classifications are deterministic and inspectable. No network request is made by this file.