![]() The Prolaris® genetic test (Myriad Genetics Inc, Salt Lake City, USA) measures the expression of 46 genes associated with cell cycle progression and cell division in PCa tissue. Several approaches have been pursued to further increase the accuracy and customization of risk stratification algorithms, including numerical risk scores, nomograms, as well as blood and genomic biomarkers. Outcomes in patients classified as ‘intermediate’ risk, however, are heterogeneous with reported rates of 5-year disease progression ranging between 21 and 91% in a recent systematic review. The specific strength of this algorithm lies in the identification of patients at low risk for disease progression who could be safely managed conservatively through active surveillance. The American Urologic Association (AUA) guidelines base risk assessment on digital rectal examination, serum prostate specific antigen (PSA) level, and PCa differentiation and abundance on prostate biopsy specimen. The management of localized prostate cancer (PCa) hinges on the risk of disease progression that needs to be counterbalanced against the patient’s overall fitness, life expectancy, and possible implications of cancer treatment. ![]()
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