Table 1
Age (years)
Comorbidity profile
Clinical scenario 1
Clinical scenario 2
Clinical scenario 3
Clinical scenario 4
Clinical scenario 5
Low risk
Young-aged man
Low risk
Middle-aged man
Intermediate risk
(lower range)
Young-aged man
65
Intermediate risk
(lower range )
Middle-aged man
75
Intermediate risk
(lower range )
Old-aged man
81
65
75
0
0
PSA
4,5 ng/ml
8,5 ng/ml
Anterior PSA
Unknown
Unknown
Normal
Normal
Prostate volume
40cc
40cc
LUTS
None
None
Stage
T1c
T1c
6(3+3)
7(3+4)
2/12 (median right lobe)
2/12( median right lobe)
2 mm/ 10 mm and 3 mm/ 13 mm
2 mm/ 10 mm and 3 mm/ 13 mm
CT
Not performed
Not performed
MRI
Not performed
No extracapsular spread. Seminal vesicle not involved.
Bone scan
Not performed
Not performed
DRE
Gleason
Nb of positive CB
Cancer length
Question n°1
Which extension work-up would you perform in this setting?
Question n°2
Which treatment options would you consider in this setting?
Question n°3
What treatment options would you suggest to the patient?
Table 2
Evaluated situation
Age(years)
Clinical scenario 6
Clinical scenario 7
Clinical scenario 8
High risk (higher range)
Young aged man
65
High risk(higher range)
Middle aged man
75
Intermediate risk (higher range)
Young aged man
65
Comorbidity
profile
PSA
0
0
13 ng/ml
17 ng/ml
Anterior PSA
Unknown
Unknown
Hard lump in the right lobe
Normal
Prostate volume
40cc
40cc
LUTS
None
None
Stage
cT3a
-
7(4+3)
7(4+3)
4/12 (both prostate lobes involved)
4/12 (both prostate lobes involved)
45 mm
85 mm
0
0
Both lobes involved. Extracapsular spread. Seminal vesicle and lymph
nodes not involved.
Both lobes involved. Extracapsular spread.
Seminal vesicle and lymph nodes not
involved.
Normal
DRE
Gleason
Nb of positive CB
Cancer length
Scanner
MRI
Bone scan
Normal
Question n°2
Which treatment options would you consider in this setting?
Question n°3
What treatment options would you suggest to the patient?
Table 3
Clinical scenario 9
Evaluated situation
Clinical scenario 10
Intermediate risk (lower range)/ Young-aged man
Age (years)
65
Comorbidity profile
0
PSA
8 ng/ml
Anterior PSA
Unknown
DRE
Normal
LUTS
None
Nb of positive CB
4/12 (both prostate lobes involved)
Pre-operative staging
Gleason score
Clinical scenario 10
T1c N0 M0
7(4+3)
7(4+3)
Bone scan
Normal
Execution of a radical prostatectomy
Pathological examination
Post-operative PSA
pT3a R0 pN0 M0
Gleason 7(4+3)
undetectable
pT3a R1 pN0 M0
Gleason 7(4+3)
undetectable
pT3a R1 pN0 M0
Gleason 7(4+3)
undetectable
PSA= 0,15ng/mL ( 8th month)
PSA= 0,30ng/mL (18th month)
Which treatment options would you consider in this setting?
-
Question n°2
Question n°3
What treatment options would you suggest to the patient?