Surgeon Experience for Gleason 8

Despite doing yearly PSA tests for the last 24 years, DREs whenever recommended by my primary care doctor, and visits to urologists in centers of excellence for the occasional second opinion, I find myself in a very serious situation. A transperineal fusion biopsy done this month has shown I have Gleason 4+4 cancer. Acinar, acinar with squamous differentiation and intraductal carcinoma appear in multiple cores. Multiple cores have over 90% involvement. There is also perineural invasion and extra prostatic extension. The MRI pre-biopsy states there is neurovascular bundle invasion on right side and contact with the seminal vesicles on the right side.

I am 72 years old, very active, and the only other major health issue is pericarditis, which is under control. Current PSA is 8.7, up from 4.8 in early December. A PSMA PET scan is scheduled for tomorrow, and a consultation with a surgeon the day after. Radiation consult is April 7.

If surgery is possible in this situation, I have read that it demands an extremely experienced surgeon, with over a 1000 hours of experience. I am in Mayo now, and I am sure they have the best. If I was a 3+4 patient any Mayo surgeon would be fine. With my situation, who would you recommend for surgery?