Table 1. Definition of very high risk prostate cancer in the current literature.

Source	Definition
Spahn et al.15	≥ 2 high-risk features (PSA > 20 ng/mL, GS 8-10, and cT3-4)
Walz et al.16
Joniau et al.17	GS 8-10 in combination with ≥ 1 other high-risk factor (PSA > 20 ng/mL and cT3-4)
Sundi et al.18	Primary Gleason pattern 5, or ≥ 5 cores with GS 8–10, or multiple NCCN high risk features
Sundi et al.19	Primary Gleason pattern 5, or ≥ 4 cores containing pattern 4
NCCN guidelines 5	T3b-T4
EAU guidelines 30	any PSA, any GS, cT3-4 or cN+*

PSA = prostate specific antigen; GS = Gleason score; NCCN = National Comprehensive Cancer Network; EAU = European Association of Urology

^*Definition used to describe high risk locally advanced tumors.