Salvage a win,

Nearly half of men will experience a biochemical recurrence following radical prostatectomy for intermediate and high risk prostate cancer. While it’s true the only curative intervention at this juncture is salvage radiation, that doesn’t mean it’s right for everyone. This contemporary review summarizes all the current tools at our disposal to rule out concurrent and/or impending metastatic disease that might obviate the benefit of several weeks of pelvic radiation. This includes PSA and PSA velocity, interval time since surgery. advanced imaging such as PSMA (if PSA sufficiently high), and genomic risk score. And don’t forget the addition of ADT if PSA >0.5. On the other end of the spectrum there are plenty of patients (read: older with low risk features per all of the above) who also need not undergo treatment since it's unlikely to cause them a problem during the rest of their lifetime. | Zaorsky, Nat Rev Urol 2021