Editor’s note: The authors of this study investigated a total of 1638 men (median age 63 years) with clinically localized prostate cancer treated with radical prostatectomy (RP) and bilateral lymph node sampling between 1989 and 2008. All patients in the study cohort had unfavorable risk features; these included preoperative prostate-specific antigen (PSA) level >20 ng/mL, Gleason score of 7–10, pT3 disease, lymph node-negative disease, and an undetectable PSA level (<0.2 ng/mL) after RP. Adjuvant radiotherapy (RT) was defined as RT administered in patients with an undetectable PSA and within 6 months of RP. Salvage RT for PSA failure (defined as a rise of ≥2 ng/mL)was delivered within 1 year after the first measurement of a detectable PSA level. The primary endpoint of the study was the risk of all-cause mortality.