Zelic R, Garmo H, Zugna D, et al. - Researchers performed a nationwide cohort study to systematically compare the prognostic performance of the most commonly used pretreatment risk stratification tools for prostate cancer. They recruited a total of 154,811 men in Prostate Cancer data Base Sweden 4.0 diagnosed with nonmetastatic prostate cancer between 1998 and 2016 and followed through 2016. They correlated the D’Amico, National Institute for Health and Care Excellence, European Association of Urology (EAU), Genito-Urinary Radiation Oncologists of Canada, American Urological Association (AUA), National Comprehensive Cancer Network, and Cambridge Prognostic Groups (CPG) risk group systems; the Cancer of the Prostate Risk Assessment (CAPRA) score; and the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram in prognosticating prostate cancer death by calculating the concordance index (C-index) and the observed vs predicted cumulative incidences at different follow-up times. In comparison with the D’Amico and D’Amico-derived systems, the MSKCC nomogram, CAPRA score, and CPG risk grouping system performed better in discriminating prostate cancer death. Clinical decision making can be improved by these tools.