This is an interesting retrospective SEER database analysis of survival in the presence of Gleason Type 5 cells. It's meant as a hypothesis-generating analysis, retrospective, with risks of selection bias and so on. Having said that, it is still interesting. The link is to a free full-text version of the analysis.Risk of Death from Prostate Cancer with and without Definitive Local Therapy when Gleason Pattern 5 is Present: A Surveillance, Epidemiology, and End Results Analysis.
Look at Figure 2. My take on that graph is if you have Pattern 5 cells, do something
. In that database, while there are differences in survival between various treatments, they're all rather similar when compared to the no-treatment survival rate.
It's sobering to note the high mortality rate for those with Type 5 cells that don't have treatment. With dominant Type 5, the survival without treatment is about
50% at 8 years; this is a serious
Figure 3 notes primary Type 5 is worse than secondary Type 5 (sigh...). However, with treatment, the survival rate at 8 years is still over 75%, so that is quite encouraging!
Bx: 6/12 pos, G9=5+4 (80%, 60%), 4+5 (2@100%, 80%, 10%), PNI+
cT3a (3T mpMRI: Bilateral EPE, NVB+, SV-, LN-)
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex, ended 3/16
PSA <0.1 : 8/13 - 5/16;
steadying? - 0.2-8/16, 0.5-12/16, 0.7-3/17, 0.8-5/17, 0.8-7/17