The age 51 should have nothing to do with favoring surgery over radiation. Radiation is safely used in many childhood cancers and in many cases favored over surgery. In some situations it is the only effective treatment.
And remember, about 35% of PCa surgeries fail and then need salvage radiation. The percentage is probably higher with the higher risk men like your husband.
JFN, I'm fairly sure it is much higher than that for high risk, but I would say the word "failure" may not be apt. I believe Dr. D'Amico said that Gleason 9 and 10 biopsy men should be told up front that if they opt for surgery and the final path shows even one of LN+, EPE+, SM+, or SVI+, they should think of subsequent adjuvant therapy (RT/RT+ADT) as an integral part
of their primary treatment -- In other words, what the literature is now calling RPMAX, the counterpart to RTMAX (external RT + RT boost +ADT). (When discussing MAXRP with my uro/surgeon, he said he would add LVI+ to the other four adverse findings.)
Confirmed G8 seems to be in an adjuvant vs. salvage limbo, especiall in light of the three recent studies that lean toward early salvage over adjuvant to prevent overtreating while still affording similar ourcomes. From what I gather from Forum Brothers, some G8's opt for very early SRT, pulling the trigger at a PSA of about
0.1 or even just under, depending on the their specific, such as pre-op PSA, number and extent of post-op adverse features, and the dynamics leafing to their BCR.
Note that my comments exlude the case of persisent PSA (0.1 or higher after RP), which usually warrants adjuvant for any Gleason score regardless of any adverse findings.