Recurrence

Here's a link to a free page at Memorial Sloan Kettering that has real statistics collected over the year on their patients. You answer a few questions and it gives you percentages in different time frames. Best wishes.
https://www.mskcc.org/nomograms/prostate/post_op

Hi,
Just remember there are so many variables with each surgery I think it would be hard to put a hard number on it. I know those number exists but each case is different. Where the cancer is located and how close to escaping the capsule, Gleason score, surgeon skill, ect, ect. If you tell us a little about your specific case other members will chime in with their experience. I had robotic surgery in 2014 with Pleural neural invasion and I am cancer free today. Other survivors have surgery with clear margins and two months later their PSA is climbing. That why tools like MRIs and PMSA PET scan are valuable tools in weighing in on your surgery success.
Dave 3+4

It can be very high. Lower with lower Gleason, PSA, and clean margins. Put you results in the monogram (only valid with no ADT, radiation). As an example a Gleason 8, 20 PSA comes back as recurrence at 5 years 63%, 10 years 80% without clean margins and 46%, 66% with clean margins. At 4+3, 10 PSA clean margins it is still 30% 5 years and 50% 10 years. At 4+3, 10 PSA clean margins it is 13% 5 years and 25% 10 years.

Can’t say it any better than clevelandguy. So many variables and those variables can be different pre surgery and post surgery. The Sloan tool is good but the numbers put it can substantially change it. If you had Gleason 8, but after surgery changed to a 7. A PET might have shown it had not left the capsule yet then it barely had so a surgeon not checking in real time during surgery which most don’t and cutting standard margin clearance based on the PET can leave you with positive margin. My Gleason from biopsy included just one Gleason 8 core. Several favorable 7’s and a couple 6’s. As mentioned earlier, your Gleason score is the highest of your highest core. You could be all 6’s, but an 8, gives you 8. The cancer protocols for mine with my Decipher was after my radical prostatectomy would need adjuvant radiation and ADT. Now after my biopsy I started looking at studies such as one that mentioned dies 4+4 equal 7. I know the accuracy of the MpMRI is highly accurate and yet only one lesion was spotted and that was not my 8. The PIRADS 4 lesion was benign. I went to review NIH studies on false negative studies and found one that reevaluated the biopsy’s of prostate’s removed from a Radical Prostatectomy (RP) with their prior core biopsies of the same prostate. 68 out of 3,105 sectors were identified with false negatives. What is significant from this study is that 63% missed were (3+4), 17% missed were (3+3), and 25% missed were (4+3). It states zero missed in (4+4). This gave me confidence or wishful thinking that I did not have Gleason 8, but Gleason 7.

Now another study reports after RP, 60% of Gleason 8’s are downgraded to a Gleason 7 if the core biopsy only had one (4+4), was less than 50 % involvement and the other cores had at least a 3 in their equation. So I believed my (4+4) is an outlier and instead of advanced (this one core) I was low intermediate. I also read they do consider low intermediate for Active Surveillance (AS), however presently everyone hears the Gleason 8 core and dictate protocol from that, so at that time and up through my surgery I was Gleason 8. Protocol with my decipher was with Radiation was also hormone therapy for 18 months to 24 months and even with surgery adjuvant hormone therapy. The Radiation oncologist’s and one surgical oncologist all but insisted I was Gleason 8. Fortunately my chosen surgeon was a wait and see guy, that no need to start adjuvant treatment unless my psa was rising regardless of protocol, and believed due to his real time pathology of my margins and lymph nodes would give me best chance for negative margin and further decrease my chances needing further treatment at that time.Now after my surgery and a review of my prostate the studies were accurate and in case my Gleason 8 was downgraded to a Gleason 7, albeit an unfavorable 7 (4+3). I just want to encourage everyone to take in all the data, and certainly in cases where you have EPE, high Gleason, lymph node involvement all those variables play significant roles in recurrance

Approximately 20% to 40% of men experience biochemical recurrence (a rising PSA level) after a radical prostatectomy. While estimates vary, roughly 25% to 35% of patients may see a recurrence over a 10-year period. Most recurrences occur within 5 years after surgery.

While that may seem like a low percentage, to some, you have to realize that the people who were cured aren’t coming back for help, Those of us who are helping people over the years with treatment mainly see people who have had reoccurrence so it really skews our information.

I suspect that moving past the aggregate numbers, the younger you are at the time of your RALP, the more likely you'll live long enough to see recurrence.

(Not based on a study or trial; just an hypothesis.)

@jeffmarc
Thanks

@retireditguy
Thank you

@clevelandguy

Thanks