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Partin Tables (Prostate Cancer)

Partin Prediction Model

Pathological Stage Estimator

Serum PSA (ng/mL)

Clinical Stage

Gleason Score (Grade Group)

Stage Logic

Enter PSA, Stage, and Gleason to resolve the pathological probability matrix.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

What are the Partin Tables?

The Partin tables (also known as the Partin nomogram) are a preoperative predictive tool for men with clinically localized prostate cancer who are considering radical prostatectomy. Using three readily available clinical variables—serum PSA level, biopsy Gleason score (or Grade Group), and clinical T stage—the tables estimate the probability of four pathological outcomes at the time of surgery: (1) organ-confined disease (OC, favorable), (2) extraprostatic extension (EPE, tumor extends beyond prostate capsule), (3) seminal vesicle invasion (SVI, poor prognosis), and (4) lymph node involvement (LNI, requires systemic therapy or extended lymph node dissection). The tables help clinicians and patients make informed decisions about treatment options (active surveillance vs surgery vs radiation), surgical planning (nerve-sparing vs wide excision), and the need for extended pelvic lymph node dissection (ePLND).

Primary Clinical Indications

Pretreatment counseling – Provides quantitative estimates of pathological stage probabilities to guide shared decision-making between surgery, radiation, and active surveillance

Surgical planning – High probability of extraprostatic extension (EPE) on one side may lead surgeon to avoid nerve-sparing techniques on that side to ensure negative margins

Lymph node dissection decisions – Risk of lymph node involvement (LNI) >5% (some guidelines use >7-10%) is an indication for extended pelvic lymph node dissection (ePLND) at time of radical prostatectomy

Active surveillance selection – Patients with high probability of organ-confined disease (>90%) and low-grade features (Grade Group 1, PSA <10, cT1c) are ideal candidates for active surveillance

Adjuvant therapy planning – High probability of seminal vesicle invasion (SVI) or lymph node involvement (LNI) may prompt discussion of adjuvant radiation or systemic therapy (hormonal therapy) after surgery

Clinical trial eligibility – Some trials use Partin table predictions for inclusion criteria or stratification

Comparison with MRI – Partin table predictions can be integrated with multiparametric MRI (PI-RADS) and MRI-targeted biopsy results for improved accuracy

Contraindications / Limitations

Not applicable to patients who received neoadjuvant therapy – Hormonal therapy or radiation prior to surgery alters pathological stage; Partin tables were derived from untreated patients undergoing immediate radical prostatectomy

Not applicable to transurethral resection of prostate (TURP) incidental diagnoses – TURP specimens may have different Gleason grading and tumor volume relationships; use with caution

Does not include modern risk factors – Does not incorporate percentage of positive biopsy cores, MRI findings (PI-RADS), PSA density, or genomic classifiers (Decipher, Prolaris, Oncotype DX). These may improve accuracy beyond Partin tables

Underestimates risk in some populations – Developed at a single tertiary referral center (Johns Hopkins) with predominantly white, high-volume surgeon patients. May not fully generalize to community settings, African American men, or other ethnic groups

Based on older biopsy schemes – The 2013 update used 10-12 core systematic biopsy; many practices now use MRI-targeted fusion biopsy, which may alter Gleason grade distribution and cancer volume

Does not predict biochemical recurrence (BCR) – Partin tables predict pathological stage, not long-term oncologic outcomes (BCR, metastasis, cancer-specific survival). Other nomograms (CAPRA, Kattan, MSKCC) are better for recurrence prediction

Requires accurate clinical staging – Clinical T stage (DRE) is subjective and operator-dependent. cT2a vs cT2b vs cT2c has high inter-observer variability. MRI may provide more accurate staging (T2 vs T3a vs T3b)

Not validated for very high-risk patients – Patients with PSA >20, Gleason 9-10, or cT3-T4 are often excluded or have limited numbers; these patients are best managed with multi-modal therapy regardless of Partin predictions

Partin Table Variables and Categories (2013 Update)

Variable	Categories	Notes	Changes from Prior Versions
PSA (ng/mL)	0-2.5, 2.6-4.0, 4.1-6.0, 6.1-10.0, >10.0	PSA value at diagnosis (not after biopsy; biopsy can transiently elevate PSA but usually not clinically significant)	PSA categories refined (previously: 0-4, 4.1-10, >10). Lower threshold (0-2.5) reflects stage migration toward lower PSA cancers.
Biopsy Gleason Score	≤6 (Grade Group 1), 3+4=7 (Grade Group 2), 4+3=7 (Grade Group 3), 8 (Grade Group 4), 9-10 (Grade Group 5)	Gleason score of the dominant/most aggressive core. 3+4=7 and 4+3=7 are separate categories due to different prognoses. Tertiary Gleason pattern 5 (e.g., 3+4=7 with tertiary 5) is rare; these are often reclassified as Gleason 8.	Gleason 7 split into 3+4 and 4+3 (important prognostic distinction). Gleason 6 is now ≤6 (previously 2-6, but Gleason 1-2 are no longer diagnosed).
Clinical T Stage	T1c (non-palpable, diagnosed by needle biopsy), T2a (palpable, <1/2 of one lobe), T2b (palpable, >1/2 of one lobe but not both lobes), T2c (palpable, both lobes), T3a (extraprostatic extension on DRE), T3b (seminal vesicle invasion on DRE)	Clinical staging by digital rectal exam (DRE). T1a/b (TURP incidental) are rare and not included. T3 disease is uncommon in the Partin cohort (most are T1c-2c).	T3a and T3b categories added (previously lumped as T3). T1c became dominant category (most prostate cancers are now non-palpable due to PSA screening).

Comparison with Other Prostate Cancer Risk Calculators

Calculator	Inputs	Outputs	Strengths	Limitations
Partin Tables (2013)	PSA, Gleason, clinical T stage	Probability of OC, EPE, SVI, LNI at prostatectomy	Simple, widely available, specific to pathological staging at surgery	Does not predict BCR; does not include biopsy core percentage, MRI; last updated 2013
CAPRA Score (Cancer of the Prostate Risk Assessment)	Age, PSA, Gleason, clinical T stage, % positive cores	10-year biochemical recurrence (BCR) risk, metastasis, prostate cancer-specific mortality	Validated for BCR, easy to calculate (0-10 score), includes % positive cores	Does not predict pathological stage; developed from community-based cohort
Kattan Nomogram (MSKCC)	PSA, Gleason, clinical T stage, biopsy core number, % positive cores, and more	Probability of BCR at 2, 5, 10 years post-surgery or radiation	Highly accurate, customizable (pre-surgery or post-surgery), includes core data	More complex (requires nomogram or online calculator), not updated as frequently
Prostate Biopsy Risk Calculator (PBCG)	Age, race, PSA, DRE, prior biopsy, family history	Probability of high-grade cancer (Gleason ≥7) on biopsy	Pre-biopsy decision tool, validated in multi-ethnic cohort (PBCG)	Does not predict pathological stage or post-treatment outcomes
Decipher Genomic Classifier	Tumor RNA expression (from biopsy or prostatectomy)	10-year metastasis risk, BCR	Adds genomic information beyond clinical variables; guides adjuvant therapy	Expensive ($4,000-5,000), not universally available, requires adequate tumor tissue
ProtecT Trial Risk Groups	PSA, Gleason, clinical T stage	Disease-specific mortality, metastasis, progression	Randomized trial data (active surveillance vs surgery vs radiation)	Limited to low-intermediate risk men; not a continuous risk model

Related Scores in Practice

In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the CAPRA Score, Pcaa Risk Calculator, Epic Prostate Symptom or the Pirls Prostate Mri to formulate a comprehensive care plan.

Last Comprehensive Review: 2026

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