Philipson RG, Romero T, Wong JK, et al. - This study was attempted to assess rates of distant metastases (DM) and prostate cancer-specific mortality in a cohort of 978 men with radiorecurrent high-risk prostate cancer (HRPCa) who previously received either external beam radiation therapy (external beam radiation therapy (EBRT), n = 654, 67%) or EBRT + brachytherapy (EBRT + BT, n = 324, 33%) across 15 institutions from 1997 to 2015. The findings imply that radiorecurrent HRPCa has an aggressive natural history and that DM is clinically evident early after biochemical recurrence. These outcomes underscore the importance of future evaluations into upfront risk evaluation and prompt systemic assessment upon recurrence in HRPCa.