1. Very low risk
PSA10
Gleason 3+3=6 positive stitches less than 2 stitches Wenbin Dai, Department of Urology, East China Hospital, Fudan University
Clinical examination: no abnormalities
Treatment options
Close surveillance
Open radical prostate cancer resection
Robot-assisted laparoscopic radical prostate cancer treatment
Radiation therapy
Observation and follow-up
2. Low risk
PSA1
Gleason 3+3=6 positive stitches more than 2 stitches
Clinical examination: tumor confined to one side
Treatment options
(mortality rate is very low in this group of patients and most treatments have good results)
Close surveillance
Open radical prostate cancer surgery
Robotic-assisted laparoscopic radical prostatectomy
Radiation therapy
Observational follow-up
3. Intermediate risk
PSA 10-20
Gleason 3+4 or 4+3
Clinical examination: tumor did not break through the prostate envelope
Treatment options
Open radical prostate cancer surgery
Robotic-assisted laparoscopic radical prostatectomy
Radiation therapy
Observation and follow-up
4. High risk
PSA >20
Gleason 4+4 or 4+5 positive stitches more than 5 stitches
Clinical examination: tumor breaks through the prostate envelope
Treatment options
(These patients have a high recurrence rate despite surgical or radiation treatment and need aggressive combination treatment to obtain better results)
Open radical prostate cancer surgery
Robotic-assisted laparoscopic radical prostatectomy
Radiation therapy combined with 2-3 years of endocrine therapy
Observational follow-up
5. Very high risk
Gleason 5+4 or 4+5
Gleason 4+4 More than 4 positive stitches
Clinical examination: tumor breaks through the prostate envelope
Treatment options
(Treatment outcome is poor in this group of patients)
Open radical prostate cancer surgery
Robotic-assisted laparoscopic radical prostatectomy
Radiation therapy combined with endocrine therapy for 2-3 years
Observation and follow-up
6. Patients with metastasis
Treatment options
Endocrine therapy
Chemotherapy
Radium 223
Immunotherapy
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