Abstract
Commonly used high-risk prostate cancer definitions, based on preoperative clinico-pathological findings, are useful but insufficient for stratifying patients’ risk of poor outcome. Therefore, several nomograms have been developed to improve the predictive value of these preoperative findings. The future for further sub-stratification and personalised medicine, however, lies within the development of biomarkers. Conclusion Prostate cancer remains the most frequently diagnosed cancer among men and high-risk prostate cancer represents an important subgroup. When diagnosed with high-risk prostate cancer, mortality rates are high if patients do not undergo treatment with curative intent. The future lies in the development of novel biomarkers, optimising pre-treatment risk stratification and identifying the true ‘high-risk prostate cancer patient’.
Highlights
ConclusionProstate cancer remains the most frequently diagnosed cancer among men and high-risk prostate cancer represents an important subgroup
Prostate cancer is the most common malignancy in men and represents one of the main causes of cancerrelated mortality
When diagnosed with high-risk prostate cancer, mortality rates are high if patients do not undergo treatment with curative intent
Summary
PCa remains the most frequently diagnosed cancer among men with high-risk localised PCa representing an important subgroup. Reported outcomes after RP vary significantly depending on the high-risk definition used and as a result of the interobserver variability of pre-treatment clinico-pathological features. Because of this heterogeneity, there is still no optimal treatment for the high-risk localised PCa patient, which does impact clinical practice and has its effect on designing randomised trials comparing treatment options. Several useful nomograms have been proposed in order to optimise the prognostic value of current clinico-pathological features. The future lies in the development of novel biomarkers and their introduction into nomograms, optimising pre-treatment risk stratification and identifying the ‘true’ high-risk PCa patient
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