What duration of androgen deprivation therapy do you use for patients with pN+ prostate cancer undergoing upfront adjuvant RT after a radical prostatectomy and pelvic lymph node dissection?

As @Dr. First Last mentioned, the Messing randomized trial (ECOG 3886) showed that lifelong ADT (vs. observation) improved overall survival in patients with pN+ prostate cancer after radical prostatectomy. This trial provides the only level 1 evidence for this patient population. Therefore, ADT shou...

Based on the Messing study, I recommend lifetime androgen deprivation, regardless of other factors. This study showed an overall survival advantage for lifetime ADT.