Risk Stratification and Selection of Management Strategy for Localized Prostate Cancer

Abstract

Localized prostate cancer presents a wide disease spectrum, ranging from indolent cases suitable for active surveillance to aggressive tumors requiring intensive multimodal treatment. Traditional risk stratification tools, such as the D’Amico risk categories and NCCN risk groups, have limitations because of their heterogeneity within each category. Incorporating novel risk stratification strategies, such as genomic classifiers and multimodal artificial intelligence assays, into clinical practice may help refine treatment decisions and optimize outcomes for patients with localized prostate cancer. However, it is important to recognize the limitations of these tools and to use them judiciously in the appropriate clinical contexts.