Editing Prostate-specific antigen (section)

====Risk stratification and staging====

Men with prostate cancer may be characterized as low, intermediate, or high risk for having/developing metastatic disease or dying of prostate cancer. PSA level is one of three variables on which the risk stratification is based; the others are the grade of prostate cancer ([[Gleason grading system]]) and the stage of cancer based on physical examination and imaging studies. D'Amico criteria for each risk category are:<ref name="D'Amico-1998">{{cite journal | vauthors = D'Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, Tomaszewski JE, Renshaw AA, Kaplan I, Beard CJ, Wein A | title = Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer | journal = JAMA | volume = 280 | issue = 11 | pages = 969–974 | date = September 1998 | pmid = 9749478 | doi = 10.1001/jama.280.11.969 | doi-access = free }}</ref>
:Low risk: PSA < 10, Gleason score ≤ 6, AND clinical stage ≤ T2a
:Intermediate risk: PSA 10-20, Gleason score 7, OR clinical stage T2b/c
:High risk: PSA > 20, Gleason score ≥ 8, OR clinical stage ≥ T3
Given the relative simplicity of the 1998 D'Amico criteria (above), other predictive models of risk stratification based on [[mathematical probability]] constructs exist or have been proposed to allow for better matching of treatment decisions with disease features.<ref>{{cite journal | vauthors = Rodrigues G, Warde P, Pickles T, Crook J, Brundage M, Souhami L, Lukka H | title = Pre-treatment risk stratification of prostate cancer patients: A critical review | journal = Canadian Urological Association Journal | volume = 6 | issue = 2 | pages = 121–127 | date = April 2012 | pmid = 22511420 | pmc = 3328553 | doi = 10.5489/cuaj.11085 | doi-broken-date = 28 November 2024 }}{{dead link|date=November 2016}}</ref>
Studies are being conducted into the incorporation of multiparametric [[MRI]] imaging results into [[nomogram]]s that rely on PSA, Gleason grade, and tumor stage.<ref>{{cite web| vauthors = Sperling D | title = mpMRI improves the accuracy of the Partin tables and other nomograms|url=http://sperlingprostatecenter.com/mpmri-improves-the-accuracy-of-the-partin-tables-and-other-nomograms/|website=Sperling Prostate Center|access-date=31 March 2016}}</ref>