Prostate cancer
Biochemical recurrence after radical prostatectomy

Boris (65 years old)

Boris, 65 years old, used to be a professional glassblower who won several prestigious international awards. He underwent RP with extended lymph node dissection (ePLND) for high-risk PCa (PSA 33 ng/ml) 2 years ago.

Outcomes

  • Stage pT2b N0
  • Pathological ISUP grade group 3 [Gleason score 4+3]
  • Surgical margins: positive
  • Post-operative PSA: undetectable

Recent diagnostic work-up

  • PSA: 1.2 ng/ml
  • PSA doubling time: 4 months
  • Choline-PET imaging: no signs of positive lymph nodes or metastases

No relevant comorbidities or medication.

Which option do you consider most appropriate for this patient?