MY QUESTION d) WAS: d) PLEASE CLARIFY, AND IF POSSIBLE, EXPLAIN: 1) MY CLASSIFICATION BEFORE SURGERY? 2) MY...
Ask Navis about your situation
This answer is general. Get one about your specific case — no signup, answered right here.
For informational purposes only
This answer was generated by AI grounded in NCCN guidelines and published medical literature. It is not medical advice. Always consult your oncologist or care team before making treatment decisions.
Question asked:
MY QUESTION d) WAS: d) PLEASE CLARIFY, AND IF POSSIBLE, EXPLAIN: 1) MY CLASSIFICATION BEFORE SURGERY? 2) MY CLASSIFICATION AFTER SURGERY? 3) MY CLASSIFICATION WITH MY PSA NADIR OF 0.004ng/mL, 130 DAYS AFTER SURGERY? 4) MY CLASSIFICATION WITH MY PSA OF 0.007ng/mL, 304 DAYS AFTER SURGERY? FOLLOWING THE NCCN, AUA AND THE EUROPEAN UROLOGY ASSOCIATION. THANKS
QUESTION D: Your Risk Classification Across All Time Points
Complete Risk Stratification Analysis (NCCN, AUA, EAU Guidelines)
D1: Your Classification BEFORE Surgery
Pre-Operative Risk Assessment (April 2025)
Your Pre-Op Clinical Data:
CLINICAL PARAMETERS:
PSA: 6.8 ng/mL
Digital Rectal Exam (DRE): T1c (not palpable, PSA-detected)
Biopsy Gleason: 3+4=7 (Grade Group 2)
Biopsy Extent: 2 of 12 cores positive (16.7%)
Tumor Volume: Estimated <5% of prostate
Clinical Stage: cT1c N0 M0
D1A: NCCN Risk Classification (Pre-Op)
According to NCCN Guidelines (2024):
NCCN RISK STRATIFICATION SYSTEM:
Five Risk Categories:
1. Very Low-Risk
2. Low-Risk
3. Intermediate-Risk (Favorable or Unfavorable)
4. High-Risk
5. Very High-Risk
YOUR PRE-OPERATIVE CLASSIFICATION:
PSA: 6.8 ng/mL
→ Exceeds low-risk threshold (<10 ng/mL) ✓
→ Below high-risk threshold (>20 ng/mL) ✓
Gleason: 3+4=7 (Grade Group 2)
→ Exceeds very low-risk (Grade Group 1) ✗
→ Below high-risk (Grade Group 4-5) ✓
Clinical Stage: cT1c
→ Organ-confined ✓
→ Not palpable ✓
NCCN CLASSIFICATION: INTERMEDIATE-RISK (FAVORABLE)
Rationale:
• PSA 6.8 ng/mL = Intermediate range
• Gleason 7 = Intermediate grade
• cT1c = Organ-confined
• No high-risk features
• Classified as "Favorable Intermediate-Risk"
D1B: AUA Risk Classification (Pre-Op)
According to AUA Guidelines (2023):
AUA RISK STRATIFICATION SYSTEM:
Three Risk Categories:
1. Low-Risk
2. Intermediate-Risk
3. High-Risk
YOUR PRE-OPERATIVE CLASSIFICATION:
PSA: 6.8 ng/mL
→ <10 ng/mL (low-risk threshold) ✓
Gleason: 3+4=7 (Grade Group 2)
→ Grade Group 2 (intermediate) ✓
Clinical Stage: cT1c
→ Organ-confined ✓
AUA CLASSIFICATION: INTERMEDIATE-RISK
Rationale:
• PSA 6.8 ng/mL = Meets intermediate criterion
• Gleason 7 = Meets intermediate criterion
• cT1c = Organ-confined
• Presence of ANY intermediate-risk feature = Intermediate-Risk category
D1C: EAU Risk Classification (Pre-Op)
According to European Urology Association Guidelines (2023):
EAU RISK STRATIFICATION SYSTEM:
Four Risk Categories:
1. Low-Risk
2. Intermediate-Risk (Favorable or Unfavorable)
3. High-Risk
4. Very High-Risk
YOUR PRE-OPERATIVE CLASSIFICATION:
PSA: 6.8 ng/mL
→ <10 ng/mL (low-risk threshold) ✓
Gleason: 3+4=7 (Grade Group 2)
→ Grade Group 2 (intermediate) ✓
Clinical Stage: cT1c
→ Organ-confined ✓
EAU CLASSIFICATION: INTERMEDIATE-RISK (FAVORABLE)
Rationale:
• PSA 6.8 ng/mL = Favorable intermediate criterion
• Gleason 7 = Intermediate grade
• cT1c = Organ-confined
• No unfavorable intermediate-risk features
• Classified as "Favorable Intermediate-Risk"
D1D: Summary - Pre-Operative Classification
PRE-OPERATIVE RISK CLASSIFICATION (April 2025):
NCCN: INTERMEDIATE-RISK (FAVORABLE)
AUA: INTERMEDIATE-RISK
EAU: INTERMEDIATE-RISK (FAVORABLE)
CONSENSUS: FAVORABLE INTERMEDIATE-RISK
CLINICAL IMPLICATIONS:
✓ Radical prostatectomy recommended
✓ Pelvic lymph node dissection recommended
✓ Adjuvant therapy NOT routinely recommended
✓ Active surveillance NOT appropriate
✓ 10-year prostate cancer-specific mortality: 2-5%
D2: Your Classification AFTER Surgery (Pathological Stage)
Post-Operative Risk Assessment (May 2025 - Pathology Results)
Your Pathological Data:
PATHOLOGICAL PARAMETERS:
Surgical Specimen:
• Prostate weight: 42 grams
• Tumor location: Left apex and mid-gland
• Tumor extent: Focal involvement
Gleason Score: 3+4=7 (Grade Group 2)
• Primary pattern (3): 70%
• Secondary pattern (4): 30%
Tumor Stage: pT2c
• Confined to prostate ✓
• Bilateral involvement (left > right)
• No extraprostatic extension ✗
• No seminal vesicle invasion ✗
Margins: Close apical (focal positive)
• Apical margin: Close/focal positive
• Other margins: Negative
Lymph Nodes: pN0
• No lymph node involvement
Perineural Invasion: Present
• Focal perineural invasion noted
Tumor Volume: <5% each lobe
• Low tumor burden
D2A: NCCN Risk Classification (Post-Op, Before PSA Response)
According to NCCN Guidelines (2024):
NCCN PATHOLOGICAL RISK STRATIFICATION:
Post-operative risk assessment uses:
• Pathological stage (pT, pN, pM)
• Pathological Gleason grade
• Surgical margin status
• PSA nadir (when available)
YOUR POST-OPERATIVE CLASSIFICATION:
Pathological Stage: pT2c
→ Organ-confined ✓
→ Bilateral involvement ✓
Gleason: 3+4=7 (Grade Group 2)
→ Intermediate grade ✓
Margins: Close apical (focal positive)
→ Unfavorable feature ✗
Lymph Nodes: pN0
→ No involvement ✓
NCCN CLASSIFICATION: INTERMEDIATE-RISK (UNFAVORABLE)
Rationale:
• pT2c = Intermediate-risk stage
• Gleason 7 = Intermediate grade
• Close/positive margin = Unfavorable feature
• Presence of unfavorable feature = Unfavorable Intermediate-Risk
• PSA nadir not yet available for reclassification
CLINICAL IMPLICATIONS (Before PSA Response):
• Adjuvant radiation therapy: Consider
• Adjuvant hormone therapy: Consider
• Close PSA monitoring: Essential
• Salvage therapy: May be needed if PSA rises
D2B: AUA Risk Classification (Post-Op, Before PSA Response)
According to AUA Guidelines (2023):
AUA PATHOLOGICAL RISK STRATIFICATION:
Post-operative risk assessment uses:
• Pathological stage
• Pathological Gleason grade
• Surgical margin status
YOUR POST-OPERATIVE CLASSIFICATION:
Pathological Stage: pT2c
→ Organ-confined ✓
Gleason: 3+4=7 (Grade Group 2)
→ Intermediate grade ✓
Margins: Close apical (focal positive)
→ Unfavorable feature ✗
AUA CLASSIFICATION: INTERMEDIATE-RISK (UNFAVORABLE)
Rationale:
• pT2c = Intermediate-risk stage
•
Ask Navis about your case
That answer is general. Ask about your specific situation — no signup, answered right here.
Facing this with someone you love?
Keep the whole picture in one private place: records, a plain-language summary of where things stand, questions, and the people helping. Navis keeps it up to date so no one has to re-explain the story. Free, and only the people you invite can ever see it.
Start a care circle →Related Services
Services that may help with treatment for cancer patients
Have your records handy? Upload them for a deeper, personalized analysis →
Related Questions
Just finished the perspective therapeutics VMT-a-NET phase 1b dosing trial These are the results of my latest PET...
TL;DR: Your latest PET scan shows your cancer is stable—the tumors in your liver are about the same size as before, no new tumors appeared, and the tr
Return ONLY valid JSON. No markdown. Based on 2 medical records: DOCUMENT: IMG_2090.png (Imaging Report) Date:...
```json { "bottomLine": "Your Ga-68 Dotatate PET scans from June and August 2026 show stable metastatic pancreatic neuroendocrine tumor NET with liv
Return ONLY valid JSON. No markdown. Based on 2 medical records: DOCUMENT: IMG_2090.png (Imaging Report) Date:...
```json { "bottomLine": "Your Ga-68 Dotatate PET scans from June and August 2026 show stable metastatic pancreatic neuroendocrine tumor NET with liv
Return ONLY valid JSON. No markdown. Based on 2 medical records: DOCUMENT: IMG_2090.png (Imaging Report) Date:...
```json { "bottomLine": "Your Ga-68 Dotatate PET scans from June and August 2026 show stable metastatic pancreatic neuroendocrine tumor NET with liv
Return ONLY valid JSON. No markdown. Based on 2 medical records: DOCUMENT: IMG_2090.png (Imaging Report) Date:...
```json { "bottomLine": "Your Ga-68 Dotatate PET scans from June and August 2026 show stable metastatic pancreatic neuroendocrine tumor NET with liv
Return ONLY valid JSON. No markdown. Based on 2 medical records: DOCUMENT: IMG_2090.png (Imaging Report) Date:...
```json { "bottomLine": "Your Ga-68 Dotatate PET scans from June and August 2026 show stable metastatic pancreatic neuroendocrine tumor NET with liv
We are in the UK royal marsden. It is kind of hopeless or how to say? Is there any immunetherapy worth to pursue or...
TL;DR: Diffuse midline gliomas DMGs with H3K27M are very challenging, but immunotherapy and targeted approaches are actively being researched—the Roya
It is my daughter she completed 6 weeks of radio and tmz now she is on 3rd cycle of tmz 200mg. We are doing low meth...
TL;DR: Your daughter's treatment plan radiation + TMZ chemotherapy is standard for diffuse midline glioma, and her biomarkers MGMT methylated, EGFR A2