The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 67-year-old retired engineering professor was found to have a prostate-specific antigen (PSA) level of 11 ng/mL on a screening test at his annual physical examination. A digital rectal examination revealed a nodule on the right side. He underwent a transrectal ultrasound-guided prostate biopsy that was notable for prostate adenocarcinoma, Gleason 3 + 4 = 7 (Gleason grade group 2; 30% Gleason 4 component) involving two cores (60% and 20% core involvement). A bone scan and pelvic computed tomography scan were negative for evidence of metastatic disease. (Should he undergo prostate magnetic resonance imaging? That seems rather common these days.) He was diagnosed with cT2b intermediate-risk localized prostate cancer (PCa) by National Comprehensive Cancer Network (NCCN) risk group and was seen in the multidisciplinary clinic to discuss management options (Table 1).

中文翻译：

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局部前列腺癌风险分层的优化

Oncology Grand Rounds 系列旨在将发表在期刊上的原始报告纳入临床背景。病例介绍之后是诊断和管理挑战的描述、相关文献的回顾以及作者建议的管理方法的总结。本系列的目标是帮助读者更好地了解如何将关键研究的结果（包括发表在《临床肿瘤学杂志》上的研究）应用于他们自己的临床实践中看到的患者。一位 67 岁的退休工程教授在其年度体检的筛查测试中发现其前列腺特异性抗原 (PSA) 水平为 11 ng/mL。直肠指检发现右侧有一个结节。他接受了经直肠超声引导下的前列腺活检，以前列腺腺癌为特征，Gleason 3 + 4 = 7（Gleason 等级组 2；30% Gleason 4 成分）涉及两个核心（60% 和 20% 核心受累）。骨扫描和盆腔计算机断层扫描未发现转移性疾病的证据。（他应该接受前列腺磁共振成像吗？现在这似乎很常见。）他被国家综合癌症网络 (NCCN) 风险小组诊断为 cT2b 中危局部前列腺癌 (PCa)，并在多学科诊所就诊以讨论管理选项（表 1）。骨扫描和盆腔计算机断层扫描未发现转移性疾病的证据。（他应该接受前列腺磁共振成像吗？现在这似乎很常见。）他被国家综合癌症网络 (NCCN) 风险小组诊断为 cT2b 中危局部前列腺癌 (PCa)，并在多学科诊所就诊以讨论管理选项（表 1）。骨扫描和盆腔计算机断层扫描未发现转移性疾病的证据。（他应该接受前列腺磁共振成像吗？现在这似乎很常见。）他被国家综合癌症网络 (NCCN) 风险小组诊断为 cT2b 中危局部前列腺癌 (PCa)，并在多学科诊所就诊以讨论管理选项（表 1）。