STHLM3 NorDCaP: prospective multicentre trial of Stockholm3 for active surveillance biopsy guidance.
BJU IntJul 1, 2026 (epub)
Nicola Giudici, Simone Scuderi, Thorgerdur Palsdottir et al.
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In 30 seconds
The STHLM3 NorDCaP trial evaluated the Stockholm3 test for predicting prostate cancer upgrading in 199 men with low-risk prostate cancer under active surveillance. The study found that 36% of men experienced upgrading, with higher median Stockholm3 scores in upgraded cases (35 vs 23, P < 0.01). The area under the curve for Stockholm3 was 0.71.
Key findings
- 36% of men were upgraded to ISUP grade group 2 or higher during surveillance biopsy.
- Men with upgraded PCa had a median Stockholm3 score of 35 compared to 23 for those without upgrading (P < 0.01).
- Stockholm3 demonstrated a sensitivity of 0.93 and a negative predictive value of 0.87 at a threshold of ≥15.
- At a lower threshold of ≥11, sensitivity increased to 0.99 with a negative predictive value of 0.93.
Why it matters
This study highlights the potential of the Stockholm3 test to improve risk stratification in low-risk prostate cancer patients, potentially reducing unnecessary biopsies and enhancing patient management strategies.