Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for Men With Adverse Pathologic Features–The Debate Continues

For men with prostate cancer who undergo radical prostatectomy and are found to have adverse pathologic features (positive margin, extraprostatic extension [pT3a], and/or seminal vesicle invasion [pT3b]), there has been a long debate regarding the benefits versus harms of 2 competing management approaches: immediate adjuvant radiation therapy (ART) and early salvage radiation therapy (eSRT). Recently, the highly anticipated results from the RADICALS-RT, 1 RAVES, 2 and GETUG-AFU-17 3 randomized trials and the ARTISTIC meta-analysis, 4 using data from the 3 trials, were published. In this article, the authors review the data from these recent publications and discuss whether these studies help settle the debate regarding ART versus eSRT.