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Prostate cancer: Risk stratification and choice of initial treatment

Eric A Klein, MD
Section Editors
Nicholas Vogelzang, MD
W Robert Lee, MD, MS, MEd
Jerome P Richie, MD, FACS
Deputy Editor
Michael E Ross, MD


Prostate cancer is the second most common cancer in men worldwide, with an estimated 1,100,000 cases and 307,000 deaths in 2012 [1]. In developed areas, prostate cancer is increasingly being diagnosed when the tumor is confined to the prostate, due at least in part, to screening with prostate specific antigen (PSA). However, prostate cancers confined to the gland may become less frequent than more invasive tumors as PSA screening rates fall [2].

For men with newly diagnosed prostate cancer, the most important factors in selecting the initial treatment include the following:

Anatomic extent of disease (tumor, node, metastasis stage)

Histologic grade (Gleason score/grade group) of the tumor

Serum PSA level


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Literature review current through: Sep 2016. | This topic last updated: Oct 18, 2016.
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