Someone in this group just yesterday responded to a similar question and provided this recent paper on the reasoning for adjuvant vs. early salvage vs salvage once PSA is above BCR (>0.2 ng/mL). It really boils down to the overall health and age of the individual couple with an assessment of the overall risk of recurrence and metastasis for the individual. I am one of those people in the “very early salvage” group - rALP was 9/22/25. I’m Stage pT3b, R1; GS=4+3; 4 positive margins including both seminal vesicles and bladder neck, Intraductal Carcinoma, Cribriform, Perineural Invasion, Decipher Score of 0.89 (very high).
This study and a few others have helped me to cement my plan - my first post op PSA was 0.03 ng/mL taken 10/29/25. I have my next blood draw for test Monday 12/12/25. If it has gone up more than 0.03 ng/mL (doubled or more), I will retest in a couple weeks to confirm results and if confirmed I will be pursuing salvage treatment which will most likely be ADT and radiation.