Editorial Improving risk stratification in patients with prostate cancer managed by active surveillance: nomogram predicting the risk of biopsy progression Active surveillance (AS) for low-risk prostate cancer has been widely embraced by the medical community, since its origins as a defined management strategy in the early 1990s [1]. Although as the present authors note, criteria for entry and intervention are yet to be standardised, virtually all authorities agree with the concept. And in fact, regardless of which published criteria are used, occult progression to advanced disease in compliant men is virtually unknown [2]. Importantly, when prostatectomy is performed after years of AS, pathological results are similar to those seen when operation is done de novo. In the present report by Iremashvili et al. [3], further evidence and refinement is supplied in favour of the AS approach. The series of 205 men is not exceptionally large, but the participants were enrolled using strict criteria, followed closely in a uniform fashion for a relatively long period (median 4.6 years or to progression), and the data were subjected to statistical analysis. By comparing the 58 men (28%) who progressed at or after their second post-surveillance biopsy vs the majority who did not, the authors developed a nomogram to stratify risk of progression. The three components of the nomogram were race, PSA density, and total number of positive cores in diagnostic and first surveillance biopsy combined. Caucasian men with