Metastatic Prostate Cancer Prognosis Calculator — CHAARTED & LATITUDE Criteria

Formula

How this is calculated

Two landmark randomised controlled trials defined widely-used risk stratifications for mHSPC. CHAARTED (Sweeney et al. NEJM 2015) classified patients as high-volume if they had visceral metastases (liver, lung, adrenal, or other organs) OR four or more bone metastases with at least one beyond the vertebral bodies and pelvis. High-volume patients gained substantially more overall survival benefit from adding docetaxel to androgen-deprivation therapy (ADT) than low-volume patients. LATITUDE (Fizazi et al. NEJM 2017) defined high-risk mHSPC as having at least two of three criteria: Gleason score 8–10, three or more bone lesions, and measurable visceral metastases. The LATITUDE criteria identify patients who benefit from adding abiraterone to ADT.

For metastatic castration-resistant prostate cancer (mCRPC), this tool applies a simplified educational score based on four prognostic factors that are consistently identified across multiple published studies (Halabi et al. 2003, 2014; Armstrong et al.): haemoglobin below 11 g/dL (low red-cell mass indicates disease burden), presence of visceral metastases, ECOG performance status of 2 or higher (reduced functional capacity), and elevated LDH above 250 U/L (a marker of tumour burden and cell turnover). The number of unfavourable factors present groups patients as Favorable (0), Intermediate (1–2), or Unfavorable (3–4). This is a simplified educational construct — formal mCRPC prognosis should use validated nomograms such as Halabi 2014 (Cancer Clinical Trials Consortium) in consultation with an oncologist.

Median overall survival varies substantially based on era, treatment, and performance status. These classifications guide treatment selection and trial eligibility — they are not deterministic. Individual prognosis depends on many factors not captured here.