A 68-year-old man with newly diagnosed prostate cancer has PSA 22 ng/mL, Gleason score 4+4=8, and clinical stage T2c. According to the D'Amico risk stratification, which category does he belong to?

• A Low risk
• B Intermediate risk
• C Metastatic risk
• D High risk ✓

Explanation

D'Amico high-risk prostate cancer requires ANY ONE of: PSA >20 ng/mL, Gleason score ≥8 (Grade Group 4-5), or clinical stage ≥T3a. This patient fulfills two criteria — PSA 22 ng/mL and Gleason 4+4=8 — classifying him as high risk. High-risk patients are typically managed with radical prostatectomy or external beam radiotherapy combined with long-term androgen deprivation therapy (18-36 months).

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.