Neoadjuvant Hormone and Radiation Therapy Followed by Radical Prostatectomy in Patients With High-Risk Prostate Cancer

PRIMARY OBJECTIVE: I. Success rate of salvage radiation therapy (SRT) measured as pathologic complete response (pCR) or pathologic near complete response (minimal residual disease, MRD) rate. SECONDARY OBJECTIVES: I. PSA decline rate after neoadjuvant treatment, rate of undetectable PSA after RP, rate of positive surgical margin, and rate of pathologic down-staging (≤ ypT2N0) II. Biochemical recurrence-free survival rate (from date of randomization). III. Metastasis free survival. IV. Prostate Cancer Death. V. Overall Survival OUTLINE: Participants are randomized to 1 of 2 arms. ARM I: Participants receive neoadjuvant hormone and radiation therapy, and then radical prostatectomy ARM II: Participants receive neoadjuvant hormone therapy, and then radical prostatectomy. After intervention, participants are followed up periodically for up to 20 years.