Prostate cancer
Adverse pathology at radical prostatectomy

Jack (59 years old)

Jack is a piano tuner of 59 years. After the diagnosis of high-risk PCa (PSA 31.7 ng/ml, cT2c, biopsy ISUP grade group 3 [GS 4+3]) his prostate was surgically removed and an ePLND was performed. Jack is otherwise healthy and has no comorbidities. After RP the PSA was undetectable.

The pathological report shows:

  • Pathological ISUP grade group 3 [GS 7]
  • SM-
  • No SVI
  • ECE (pT3)
  • 3 positive LNs

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