Prostate cancer
INACTIVE --- Adverse pathology at radical prostatectomy

Tobias (57 years old)

Tobias is a 57-year old installer of security systems and amateur darts player. After the diagnosis of high-risk PCa (PSA 23.6 ng/ml, cT2c, biopsy ISUP grade group 4 [GS 4+4] his prostate was surgically removed and ePLND was performed. After RP the PSA was undetectable.

Pathological testing of the RP specimen shows:

  • Pathological ISUP grade group 4 [GS 4+4]
  • SM+
  • SVI
  • ECE (pT3)

In addition, 4 out of 20 LNs removed during ePLND were positive.

Which of the following options do you consider most appropriate for this patient?