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Prostate-specific antigen (PSA)–induced stage migration occurs in many patients who originally were diagnosed with less-advanced disease, and 30% to 40% of patients who undergo radical prostatectomy ultimately will exhibit detectable PSA levels (biochemical failure). A major clinical challenge in treating patients with biochemical failure is the inability to determine definitively whether a given patient has experienced local, systemic, or combination failure. To explore the value of salvage radiotherapy in such patients, investigators from a Maryland academic center performed a retrospective review of 635 men who underwent radical prostatectomies for T1 or T2 prostate cancer and experienced PSA-only relapses (defined as a single PSA value …