A Gleason, 4+3 does not call for two years of ADT. But after a relapse and salvage radiation, this is the following information that the NCCN provides.

Key points from NCCN and recent evidence:

24 months of ADT with salvage radiation improves outcomes for men with adverse features (including Gleason 4+3).

Shorter durations (e.g., 6 months) have not shown the same survival benefit as 24 months in this context.

The decision may be individualized based on other risk factors, side effect tolerance, and patient preference, but 24 months is the standard for higher-risk cases per NCCN.