Table 4. Triggers for intervention (treatment or further characterisation).
| Study | Gleason score | Positive cores No. (%) | MCL | PSAV | PSADT (yr) | DRE |
|---|---|---|---|---|---|---|
| MSKCC (10) | >6 | >3 | >50% | – | ||
| John Hopkins (11) | >6 | (>33% of total cores) | >50% | – | – | – |
| UCSF (12) | >6 | >2 | – | – | <3 | – |
| PRIAS (13) | >6 | ≥3 | – | <3 (yearly repeat biopsies) | – | |
| University of Miami (14) | >6 | >2 | Any increase in MCL | – | – | – |
| Royal Marsden (15) | ≥4+3 | (>50% of total cores) | – | >1 ng/mL per year | – | – |
| ProtecT (16) | 50% in PSA increase triggered review | |||||
| University of Toronto (17) | Pathology upgrade | – | – | – | <3 (MRI or repeat biopsy undertaken) | – |
| University of Copenhagen (18) | ≥4+3 | >3 | – | – | <3 | – |
| St Vincents, Australia (19) | >6 | (>20%) | >8 mm | >0.75 | <3 | T2b |
| Goteborg (20) | Any gleason or TNM upgrade | – | – | – | Any PSA progression | Any DRE change |
| Multi–institutional Canary PASS (21) | >6 (VLRPC, LRPC), >3+4 (IRPC, HRPC) | >2 | (≥34%) | – | – | – |
| Milan (SAINT + PRIAS) (22) | >6 (SAINT) | >20% of cores (up to 2012), >25% cores [2012–2016] | >50% | – | <3 | > T2c |
| >6 (PRIAS) | >2 | – | – | <3 (where PSADT 3–10 years and biopsy not within 12 months—additional biopsy indicated) | > T2c | |
LRPC, low-risk prostate cancer; IRPC, intermediate-risk prostate cancer; MRI, magnetic resonance imaging; MCL, maximum cancer length.