The UroToday article begins with Agarwal describing his understanding of what Kishan et.al. studied as the evidence for "the utility of androgen deprivation therapy in patients who have biochemical recurrence after prior definitive therapy." Kishan doesn't disagree.

Kishan et.al., in the Lancet article under discussion, appear to be saying something different. Under a headline "Interpretation" they write:

"Our findings, we believe, provide the strongest level of evidence to date suggesting there might be no meaningful overall survival benefit to adding hormone therapy, either short-term or long-term hormone therapy, to PORT [ i.e. Post Operative Radiation Therapy } for PSA 0·5 ng/mL or less, with no apparent difference in efficacy for short-term versus long-term hormone therapy."

So, in the published study it seems the patients studied were those who had post operative radiation therapy for any reason, whether that was the discovery of positive margins immediately after surgery or if a steady PSA increase at some point afterwards caused a diagnosis of biochemical recurrence.

If I thought these findings applied to my case, I'd ask my RO about this study. If things did not seem clear I might then seek a second opinion from Kishan or his group.

A diagnosis of biochemical recurrence means there is proof of actively growing cancer. Positive margins are a risk factor for eventual biochemical recurrence.