Localized prostate cancer

Prostate cancer that has not spread beyond the prostate

Locally Advanced prostate cancer

Patients with T3b or T4 disease on their initial evaluation based upon the presence of presumed extra-prostatic extension and/or seminal vesicle involvement, or invasion of adjacent organs and/or regional LN metastases by radiological investigations

Biochemical recurrence

A rise in serum PSA and not accompanied by signs, symptoms, or radiographic evidence of locally recurrent or disseminated disease. (by conventional Imaging and/or PSMA-PET)

A)  PSA persistence/recurrence after RP

Failure of PSA to fall to undetectable levels (PSA persistence) or undetectable PSA after RP with a subsequent detectable PSA that increases on 2 or more determinations (PSA recurrence) or that increases to PSA >0.1 ng/mL.

B) Biochemical recurrence after EBRT with or without hormonal therapy is defined as a PSA rise by 2 ng/mL or more above the nadir PSA

Metastatic Hormone Sensitive Prostate Cancer (MHSPC)

MHSPC is diagnosed when cancer has spread beyond the prostate to the body and serum testosterone levels are typically >50 ng/dL ,Treatment is often effective with low testosterone levels .

MHSPC High volume criteria ( CHAARTED trial )

Presence of visceral metastases

and/or ≥4 bone metastases, including at least one beyond the vertebral bodies and pelvis

MHSPC low volume criteria are defined as those who do not meet the high volume criteria

MHSPC High risk criteria ( LATITUDE trial )

 At least two of :

 a-Gleason score of ≥ 8

b-Bone metastasis of ≥ 3

 c-Presence of Visceral metastasis

MHSPC low risk  criteria are defined as those who do not meet the high risk  criteria

Non metastatic CRPC

Males who are diagnosed with CRPC at a time when the only manifestation of progressive disease is an increase in serum PSA level, without demonstrable radiographic disease progression (on bone scan and conventional CT) or by PSMA-PET  involving specific organs, , with PSA DT ≤10 months, and a serum PSA ≥2 ng/mL.

Metastatic CRPC 

Metastatic castration-resistant prostate cancer (CRPC) is advanced prostate cancer with evidence of disease progression and spread to other parts of the body despite castrate levels of serum testosterone (<50 ng/dL) after medical or surgical orchiectomy.