Would you treat a patient with prostate biopsy (and or MRI) suspicious for extraprostatic extension as high risk if they otherwise have IR disease factors?

If a patient has only IR disease factors but "findings suspicious of extraprostatic extension" on biopsy or MRI or both, would this upstage the patient to cT3 disease? Would you recommend long or short-term ADT? Would you treat pelvic LN or only Prostate and proximal SV?

Answer from: Radiation Oncologist at Academic Institution

Men in the intermediate risk category are a heterogeneous group, and clinical factors can be a useful way to further stratify risk in this group. In our practice, because of an institutional outcomes study, we primarily use % positive cores > 50% as a means to select men for the more aggressive t...

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Would you treat a patient with prostate biopsy (and or MRI) suspicious for extraprostatic extension as high risk if they otherwise have IR disease factors?

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