For what it's worth, mine is an '04 with 170k miles on it and not one lick of
trouble yet.
*knock wood*
I've already had to replace the radiator, in fact. Seems the gasket between the
aluminum core and the plastic tanks gives up after time?
In any event, first thing I did when I bought the truck new way back then was replace the stock thermostat with a 180F one - not so much out of any fears of future issues, but that I don't like any engine running as hot as they do them these days.
(Spare me the explanations and excuses for why they can do that - I wanted the thing to run cooler intentionally, for better or worse, from the get-go.)
She's also never had anything other than Mobil1 in her, too.
The 5.7 has been absolutely bulletproof.
OH, almost forgot the OP's question:
If it's me, that particular engine would be totally rebuilt, including spending some time at the machine shop to square away flat surfaces and every dang thing else you do when you properly rebuild one.
If somebody gets away with just head gaskets, they need to immediately buy lottery tickets afterwards.