Overall risk - high side of low category. cT2a. 3+3. 50% cores positive.
PNI present. Tumour sits near capsule and left penile nerves.
Decipher - 20% chance of high risk. mpMRI - no visible spread.
MSKCC nomograms - 82% or 74% organ confined (3+3 or 3+4)
Dr's say radiation or RP surgery are equivalent for cancer control. Is this really the case?
Those nomogram numbers give me pause - up to 18-26% chance of escape. So question becomes whether radiation could be better to take care of the escaped bits, just to be on the safe side, design a treatment that assumes some escape?
Is there data comparing RP and SBRT cancer control specifically for low-intermediate risk recurrence? I would expect that radiation could be superior if they radiate around the walnut to kill the local microbits that could have leaked out? Similarly considering the PNI.
Any thoughts are appreciated, thank you.