II. Indications
- Prostate Cancer Management decision making tool
- Assessment of risk of Prostate Cancer related death based on Prostate Cancer grading, staging and PSA
- Used in conjunction with Charlson Comorbidity Index (Comorbidity-Adjusted Life Expectancy)
III. Criteria: Required for the algorithm
IV. Evaluation: Stage T1a to T2a
-
Gleason Score 2-6
- PSA <10 ng/ml
- Very low risk
- Criteria for low risk (see below) not met
- Low risk
- Three or more core biopsies positive or
- Prostate Cancer involves >50% or more of sample or
- PSA Density =0.15
- Very low risk
- PSA 10-20 ng/ml: Intermediate risk
- PSA >20 ng/ml: High risk
- PSA <10 ng/ml
-
Gleason Score 7
- PSA =20 ng/ml: Intermediate risk
- PSA >20 ng/ml: High risk
-
Gleason Score 8-10
- High risk regardless of PSA
V. Evaluation: Stage T2b or T2c
-
Gleason Score 2-7
- PSA =20 ng/ml: Intermediate risk
- PSA >20 ng/ml: High risk
-
Gleason Score 8-10
- High risk regardless of PSA
VI. Interpretation
- See Prostate Cancer Management
- Very low risk
- Prostate Cancer unlikely to cause serious morbidity or mortality within 20 years
- Low and moderate risk
- Prostate Cancer unlikely to cause serious morbidity or mortality within 10 years
- High Risk
- Prostate Cancer could result in serious morbidity or mortality within 5 years