High Risk Prostate Cancer: What is it?

High-risk prostate cancer (HRPC) accounts for just 10% to 20% of new diagnoses yet accounts for two-thirds of prostate cancer mortality at 10 years. Traditional risk stratification using prostate-specific antigen, grade group, and stage has proven insufficient, failing to capture the disease's heterogeneity. Real-world studies underscore these limitations, driving the need for more precise tools. Advances in molecular subtyping, genomics, and artificial intelligence are reshaping classification models, aiming to personalize treatment decisions. Validating these innovations will refine risk stratification, enabling nuanced categorization that reduces overtreatment while preserving oncologic outcomes-ultimately advancing the care of patients with HRPC.