Prostate cancer
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 4 [GS 8 (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 4 [GS 8]

  • SM+

  • SVI

  • ECE/pT3

In addition, 4 out of 26 LNs removed during ePLND were positive.

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