Biopsy Partin Table Results?

@ginger38314 I'm right there with you and waiting on a Prolaris test which biopsy lab had ordered which I understand is similar to the Decipher. How long ago were you diagnosed and would you mind discussing the details?

@ireland1964 When the Dr. Geo podcast posted their interview with Dr.Epstein, at 1:01:40 Eptein was asked how can a patient who would like a 2nd opinion contact him? He said the easiest and best way is to directly email him. He claimed the email goes directly to him. He then spelled out his email address. I had to listen a few times to get what I think is the address:

jepstein@impllc.com

He goes into some detail about how some patients have trouble getting their slides from their original provider and how to deal with that, etc.

The podcast: https://www.youtube.com/watch

@ireland1964
Lymph nodes and Seminal vesicles definitely a no.

Just not sure about the EPE. 23% is low. Usually, they just say you have it or you don’t.

Originally my mri was ambiguous so they did a urine biomarker test and that
came up high so proceeded to biopsy 6 weeks ago 2 of 12 3+4 taken from a
.8cm lesion .14 psa density psa4.9, core involvement 20 and 30%. Originally
the urologist offered active survalance and a decipher test but declined
but 2 weeks ago asked for a decipher test and waiting for results. I just
want to see where I stand as far as different radiation treatments and want
to avoid adt therapy whenever possible and if it comes in high will
probably proceed to a Urology surgeon which I have an appointment on Sept
28th. Thanks for responding.

I found an ASCO article published in 2022: "How Do Commonly Used Predictive Models in Prostate Cancer Compare?" https://dailynews.ascopubs.org/do/do-commonly-used-predictive-models-prostate-cancer-compare

that discussed four of this type of model: MSK model, Briganti nomogram, Partin Table, and Michigan model. The predictions produced by the Michigan model were found to be closest to what actually happened.

Partin Table has been around for decades, although it has been updated regularly, apparently. However, the ASCO article pointed out, that as of 2022:

"Another important limitation of predictive models in prostate cancer is the lack of contemporary imaging, such as multiparametric MRI, incorporated into risk estimates. Future models are also likely to consider tumor genomics, which are currently being evaluated in prospective trials for risk stratification and treatment selection. A common aphorism in statistics, “all models are wrong, but some are useful,” is relevant here. Models are one of many risk-stratification tools, and it is critical for clinicians to understand their external validity as well as their inherent limitations."

P.S. this video, "Prediction of Extraprostatic Disease with Dr. Albala" could have info of use. At minute 7:00, Dr. Albala briefly discusses his use of Partin Table data.

@ginger38314 Feel like I'm on the same road behind you
Psa 4.37
Stage T1c Group II and no PNI
I'm 4 weeks out of biopsy with 9 of 15 cores involved
Left clear
Right (4) 3+3 and (2) 3+4 with 10% pattern 4 and 35% involved
Lesion 3+4 10% and 45% involved
Mri shows legion 1.6 x 1.9 x 2.5cm oval shape w/irregular margin.
I calculated my psa density to be .137
My Urologist seems unbothered by any of this and gave me option for every treatment that is out there OR active surveillance. I'm also waiting on a genetic test called Prolaris and beginning the search for a second opinion.
I don't really like the radiation idea and would probably prefer surgery and attacking this straight on. Of course, like to know how certain the cancer is contained, and this ADT doesn't sound good. From my limited understanding is a nerve sparring RALP or Retzius Sparring (If can find a place) depends on whether the Lymph and Vesical are needing to be involved.
There is a lot to handle and I thank God for sites and people like you even though I'm sure we all wish not to be members.
Please keep me posted on everything and praying for the best.

I had 2 cores 3+4 20 &30% involvement and 10%&30 component of 4, taken from a .8cm lesion. Luckily I was referred to OHSU which is the #1 cancer center in Oregon I would like to see about prostate seed implantation because it usually works better with average prostate sizes mine is 35cc, and is supposed to be less side effects but will see what they say tomorrow if my cancer would have been 3+3 in the same senerio definitely would have chosen AS but hopefully can be done with whatever treatment I decide by years end and next year it will be in my rear view mirror.

I will let you know tomorrow what the oncologist says. One good thing about surgery if it comes back you can always go the radiation route.

@ginger38314 I glad to hear you have the opportunity to work with such a great cancer center and sounds like your initial urologist is good. Mine basically left me with every option and to let him know what I decide to do.
MRI shows my prostate size at 31.88ml so not sure if that's a good candidate for the seeds as well.
Did you every look into Focal therapy like Tulsa Pro etc?
So far I'm not a huge fan of radiation treatment options but not excited for surgery either but who is. The nerve sparring especially Retzius sounds very promising if eligible but it's still early diagnosis for me
I wish you the best of luck on your upcoming appt.