Prostate cancer
ESMO 2026

A 67-year-old man diagnosed with non-metastatic PCa and high-risk features

A 67-year-old man was recently diagnosed with prostate cancer.

  • Medical history: no relevant comorbidities or medication
  • ECOG PS: 0
  • PSA: 28.6 ng/ml
  • Other lab values: normal
  • Clinical stage: cT3a
  • mpMRI: PI-RADS 5 lesion in the left peripheral zone with evidence of extracapsular extension; no seminal vesicle invasion
  • Prostate biopsy: ISUP grade group 5 (Gleason score 4+5)
  • Bone scan and CT scan:
    • No pelvic lymph node involvement
    • No distant metastases

Which treatment option would you choose for this patient?