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@jim18 Hi, I have always heard that the reoccurrence rate between robotic surgery and radiations is about equal. From the Mayo clinic . “In one study, survival at 10 years was greater than 99% for men with lower risk disease who had either surgery or radiation. Even among men with higher risk prostate cancer, survival remained high, at about 96% for both treatments.”
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@clevelandguy Yes, the 15-year survival rate for SK was 99% for 3+4 (my mistype in post; this had 13% 5 year and 25% 10 year recurrence); that goes to 96% for 4+3 and 91% for 4+4 at time of RALP with no known cancer outside prostate margins. After recurrence usually have radiation. If it goes metastatic than ADT follows. Death rates much lower than recurrence rates. I took this to be how likely is RALP to be one and done. Even with 3+4 and favorable surgical outcomes recurrence is still significant. Older numbers are probably skewed down when RALP was still common on 3+3 cancer with a 10-year recurrence of 5%.
@clevelandguy
I keep running into people who have gone 15 20 and 30 years with Gleason nine and are still around.
I was a 4+3 and had surgery followed by radiation a few years later and I have BRCA2 and I’m still around after 16 years.
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@clevelandguy Yes. For non-metastatic prostate cancer, older research showed a slight overall survival advantage for surgery, but it was biased because younger, healthier patients were more likely to get surgery. Later randomised trials like ProtecT (2023) found 15-year overall survival to be identical for both treatments, at 97%:
https://www.nejm.org/doi/full/10.1056/NEJMoa2214122