How would you manage a patient with PSA persistence after RALP demonstrating metastasis in regional lymph nodes without further evidence of disease on bone or CT scans?

First, if possible, I would try to get a PSMA PET/CT. If that is negative, this patient should be started on long-term ADT. In terms of radiation, if they were a candidate for radical prostatectomy, the age/performance status question is probably not a major concern unless their health status has un...