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Editor’s note: Approximately one-third of patients who undergo radical prostatectomy (RP) for localized prostate cancer will present with biochemical recurrence in the absence of metastasis within 10 years of surgery. The most appropriate time to initiate hormone therapy in these patients, as well as the role of chemotherapy or salvage radiotherapy, remains unclear. Existing evidence concludes that prostate-specific antigen doubling time (PSA DT) after recurrence, the time from surgery to recurrence, and the pathological Gleason score at the time of surgery, are indicators of future disease progression.