D'Amico Risk Stratification for Localised Prostate Cancer
Stratifies localised prostate cancer recurrence risk after definitive treatment (D'Amico 1998). Combines PSA, Gleason and clinical T-stage. Underpins NICE NG131 treatment recommendations.
Score interpretation
→ Active surveillance preferred (NICE NG131): PSA every 3–4 months × 1 year then 6-monthly + DRE annually + multiparametric MRI at 12–18 months + repeat biopsy if progression. Radical treatment (RP / EBRT / brachytherapy) if patient choice or progression.
→ Radical treatment (radical prostatectomy or external beam radiotherapy ± 4–6 months ADT). Active surveillance possible only in selected favourable-intermediate disease. Brachytherapy (LDR/HDR) alternative.
→ Radical EBRT + 2–3 years long-term ADT (LHRH agonist) preferred per NICE NG131 / ProtecT / STAMPEDE. Radical prostatectomy alternative with adjuvant/salvage RT as needed. Multidisciplinary uro-oncology MDT.
→ EBRT to prostate ± pelvic nodes + 3 years ADT; consider docetaxel or abiraterone/apalutamide upfront (STAMPEDE M0 high-risk arms). Genetic testing (BRCA, mismatch repair). Surgery only in selected centres.
Interpretation bands for the D'Amico. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Gleason Score / Grade Group for Prostate Cancer · Prostate Cancer
- Prostate Cancer Risk Stratification (NICE / EAU) · Prostate Cancer
- UCSF-CAPRA Score for Prostate Cancer · Prostate Cancer
- PSA Doubling Time (PSADT) Calculator · Prostate Cancer
- D'Amico Risk Classification for Prostate Cancer · Prostate Cancer
- PSA Velocity and PSA Density · Prostate Cancer
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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.