Risk Group | Grade Group | Clinical Stage | PSA | # Cores Positive | % Core Involvement | PSA Density | Further Workup | Treatment Recommendations | Metastatic risk on surveillance |
---|---|---|---|---|---|---|---|---|---|
Very Low | GG1 | cT1-T2a | < 10 | < 1/3 | < 50% | < 0.15 | none | Active Surveillance | < 1% @ 10-15yrs |
Low | - | Active Surveillance (unless high risk for progression) |
~3% @ 10-15yrs | ||||||
Intermediate Favorable | GG1 GG2 |
cT2b-c | 10-20 <10 |
* | RALP +/- PLND XRT +/- ADT |
> 10-20% @ 15yrs | |||
Intermediate Unfavorable | GG2 GG3 |
cT2b-c | 10-20 < 20 |
* | RALP + PLND XRT w/o ADT |
||||
High | GG4-5 | cT3-T4 | > 20 | CT +/- MR bone scan Consider genetic testing |
RALP + PLND XRT + ADT ADT only (palliative option) |