@jim18 While I agree with you that there might be no difference in ‘long term outcomes’ - which is survivability vs lethal outcome - I do think there is a difference if you factor in ‘metastasis free’ survival.
Two men may both live 15 years after treatment, but the addition of ADT ‘could’ make those 15 years event free, while not adding ADT might lead to recurrence or worse, metastasis and all the treatment that goes with it.
Six months of Orgovyx (not Lupron!) is totally do-able and only mildly annoying if you follow a physical exercise regimen of cardio and weight training.
I feel, personally, that it is a small price to pay for that added measure of success. Even Artera AI only has the knowledge that we’ve gathered SO FAR; who knows what gene on that humongous DNA chain will be discovered down the road, showing a peculiar mutation which responds favorably to ADT?
Just my thoughts sculpted by the saying ‘We don’t know what we don’t know’. Best,
Phil