University of Wisconsin Biopsy-integrated Algorithm for Determining Gleason 6 Upgrading Risk (BADGR):
The Biopsy-integrated Algorithm for Determining Gleason 6 Upgrading Risk (BADGR) is a nomogram or prediction tool that can be used for men who have been diagnosed with Gleason 6 prostate cancer. Despite a diagnosis of Gleason 6 cancer, 35-50% of men will experience upgrading or have higher-grade cancer (Gleason 7 or above) after radical prostatectomy. BADGR is a prediction tool can be used to estimate a patient’s probability of upgrading using variables available at the time of diagnosis. Patients and clinicians may use this information as they discuss treatment options such as active surveillance, radical prostatectomy, or radiation therapy.
The nomogram cannot be used in the following situations:
- Gleason 7 found on biopsy
- Fewer than 10 cores were obtained on biopsy
- Patient received neoadjuvent therapy
The following information available
at diagnosis is required for use of the nomogram:
- PSA (prostate specific antigen) and Prostate size on ultrasound
- or PSA density
- Height and weight
- or BMI (body mass index)
- Number of cores positive for cancer
- Maximum % cancer involvement of any core
The methods used to develop this tool are described in the following publication:
Truong M, Slezak J, Lin CP, Viacheslav I, Sado M, Razmaria AA, Leverson G, Soloway M, Eggener SE, Abel EJ, Downs T, Jarrard DF.
Development and Multi-institutional Validation of an Upgrading Risk Tool for Gleason 6 Prostate Cancer.
(In press), 2013.