Prostate cancer
Adverse pathology at radical prostatectomy

Gary (69 years old)

Gary is a 69-year-old retired violist. He was recently diagnosed with high-risk PCa (PSA 32.2 ng/ml, cT2b, biopsy ISUP grade group 3 [GS 4+3], organ confined according to MRI). Larry was treated with RP + ePLND.

The pathology report shows:

  • Pathological ISUP grade group 4 [GS 4+4] (upgrading)
  • SM+
  • SVI
  • ECE (pT3)
  • pN0

After RP, PSA was undetectable. Larry is otherwise healthy and has no comorbidities.

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