A 60-year-old gentleman presented with mild LUTS and raised PSA of 8.7ng/ml. 8yrs back he had an episode of retention with impacted stone in urethra. That time also PSA was 7.8ng/ml. Transurethral lithotripsy and prostatic biopsy (not TRUS-guided) performed but biopsy was prostatitis. For 8yrs PSA never came down.
Now, mpMRI suggests a suspicious nodule in the left poster lateral region. No LN enlargement.TRUS biopsy Adenocarcinoma of prostate, 20%core involvement, GS 3+3, PNI present. Now, should I go for metastatic work up or not? If metastatic workup is negative, what is the practically acceptable management?
