@jeffmarc

Yes, it is real conundrum.
Some studies showed that IDC has the best result with initially having RP , but I am sure that it might change over time.
Same way that studies can not agree about cribriform lately.

I found the newest study at ASCO 2026 that concluded this :

"After adjustment for comorbidities, stage, grade, and treatment, IDC-P was not independently associated with higher mortality. Conclusions: Our population-level analysis confirmed that IDC-P is associated with a more aggressive clinical phenotype. Despite this, we found that oncologic outcomes did not differ once disease severity and treatment were accounted for. Guideline-concordant management remains appropriate, though the rising detection of IDC-P and its biologic underpinnings merit ongoing investigation."

All in all - it all can look like "dooms day" or just as "mehhh, it is just a stronger bugger than a regular bugger" 😋, depending of how one wants to see it. When one looks at OS , one really wonders if it really makes such a HUGE difference - one just needs to be very vigilant and treat accordingly. All else is in "god's hands". *sigh