Table 2

Triggers for radical treatment

Arm 1Arm 2
According to current practice
(the urologist’s judgement)
IMRI progression in lesions with confirmed Gleason pattern 4
  • Increase in PI-RADS score to 4 or 5

  • High suspicion of extracapsular extension or seminal vesicle invasion (level of suspicion to be 4 or 5 on the Likert scale)

IIPathological progression
  • Gleason pattern 5

  • Primary Gleason pattern 4 in any core with ≥5 mm cancer

  • ISUP grade 2 in ≥3 cores (or ≥30% of cores if >10 systematic cores), or ≥10 mm cancer in one core (systematic or targeted)

  • ISUP, International Society of Urological Pathology; PI-RADS, Prostate Imaging Reporting and Data System.