ArticleAdvances in therapy2026
Criteria Clinicians Use to Classify Patients as High Risk in Biochemically Recurrent Nonmetastatic Castration‑Sensitive Prostate Cancer.
Article in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionWe investigated the real-world criteria and thresholds physicians use to classify patients with nonmetastatic castration-sensitive prostate cancer with biochemical recurrence as high risk, and how these align with guidelines.
methodsDescriptive analyses were conducted using data abstracted from an independent, retrospective, cross-sectional survey completed by urologists and radiation oncologists in the USA between April and November 2023. Physicians provided their perspectives and extracted chart data for the last 6-8 patients they diagnosed with high-risk biochemical recurrence.
resultsThe cohort included 87 physicians (79% urologist, 21% radiation oncologist), who reported data for 460 patients. Physicians believed in using multiple factors for risk stratification, notably prostate-specific antigen doubling time (94%), absolute prostate-specific antigen rise following definitive therapy (89%), and Gleason score (87%). Over half named prostate-specific antigen doubling time as the most important factor. Physicians used a median (interquartile range) prostate-specific antigen doubling time threshold of 6.0 (6.0-9.0) months when identifying patients with high-risk biochemical recurrence. At the patient level, prostate-specific antigen doubling time (58%), Gleason score (44%), and absolute prostate-specific antigen rise following definitive therapy (43%) were the most frequently reported factors used for determining high-risk biochemical recurrence in the real world.
conclusionsPhysicians use multiple clinical factors to identify high-risk biochemical recurrence. These factors generally align with guidelines. However, physicians generally used a more restrictive prostate-specific antigen doubling time threshold than many guidelines recommend. Discrepancies present an opportunity for further education, potentially expanding the pool of patients with high-risk biochemical recurrence who may benefit from recent advances in management.
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