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This is from the top surgeon and hospital in the US, or one of the top three. A psa failure rate of 30% over ten years which would lead to hormone therapy is quite in line with other reports and findings from the psa era. Mayo Clinic reports similar psa recurrence rates (for all surgical patients) based on PATHOLOGICAL findings in a journal article from 2007. This report is based on CLINICAL (pre surgical) high risk men. All men with any pathologic G 4 or 5, add those with positive margins, add with extension and vesicle invasion (pT3), and they are at higher risk of recurrence, plus positive node men and then add organ confined pG6 occasional failures and you will add to 30% recurrence after ten years. I think that this report is actually a strong result for men often referred to radiation as unsuitable for surgery. There is increasing evidence that treatment, and specifically surgery, for higher risk men is a better choice than for G6 (or lower) men.
Peter Scardino has recently said that with a 1% cancer mortality after 15 years with pathological G6 patients one must question how many of them truly required surgery.
