For low ARRA score localized prostate cancer, surgery may be preferred over radiation and ADT to avoid hormonal therapy morbidity.

“so yeah in my opinion if you can treat someone's localized prostate cancer and save them the morbidity from systemic hormonal therapy that's a huge win for the patient and so that's exactly another way that you could use the arra score or other scores that predict aggressiveness is to say hey if this is a low arra tumor let's do surgery because we can treat them successfully with surgery and avoid any exposure to Total andren suppression which you know is incredibly morbid for these individuals”