Introduction: To assess the performance of five previously described clinicopathological definitions of low-risk prostate cancer (PC).

Materials and Methods: Men who underwent radical prostatectomy (RP) for clinical stage ≤T2, PSA <10 ng/mL, Gleason score <8 PC, diagnosed by transperineal template-guided saturation biopsy were included. The performance of five previously described criteria (i.e., criteria 1–5, criterion 1 stringent (Gleason score 6 + ≤5mm total max core length PC + ≤3mm max per core length PC) up to criterion 5 less stringent (Gleason score 6-7 with ≤5% Gleason grade 4) was analysed to assess ability of each to predict insignificant disease in RP specimens (defined as Gleason score ≤6 and total tumour volume <2.5mL, or Gleason score 7 with ≤5% grade 4 and total tumour volume <0.7 mL).

Results: 994 men who underwent RP were included. Criterion 4 (Gleason score 6) performed best with area under the curve of receiver operating characteristics 0.792. At decision curve analysis, criterion 4 was deemed clinically the best performing transperineal saturation biopsy-based definition for low-risk PC.

Conclusions: Gleason score 6 disease demonstrated a superior trade-off between sensitivity and specificity for clarifying low-risk PC that can guide treatment and be used as reference test in diagnostic studies. prostate cancer screening (PSA), testing practices, United Kingdom, Australia, qualitative study


prostate cancer screening, transperineal saturation biopsies, qualitative study

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