Risk/stage | Survival | Time interval to transplant | Additional considerations |
Very low risk | <1% risk of mets/death over 15 years | None | Surveillance is strongly recommended |
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| Extenuating circumstances may require treatment | ||
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Low risk | ~2 to 3% risk of mets/death over 15 years | None | Surveillance is strongly recommended |
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| Extenuating circumstances may require treatment | ||
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Low-volume intermediate risk
| <5% risk of mets/death over 15 years | If surveillance, no wait time If treatment initiated, and nomogram predicts cancer-specific death over the next 15 years <10%, no wait time | Surveillance or treatment, depending on patient and cancer characteristics |
High-volume intermediate risk, high risk, or very high risk
| 20 to 70% risk of mets/death over 15 years | If treatment initiated, and nomogram predicts cancer-specific death over the next 15 years <10%, no wait time | Treatment |
Metastatic castration-sensitive | Median survival ~5 to 6 years | If stable disease for 2 years with prolonged estimated life expectancy, may consider transplant | Best systemic therapy ± local treatment |
Metastatic castration-resistant | Median survival 2 to 3 years | Not a SOT candidate | Best systemic therapy |
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