Disease recurrence after radical prostatectomy. Contemporary diagnostic and therapeutical strategies.

In this paper the authors provide an overview of contemporary diagnostic and therapeutic strategies in patients with disease recurrence after radical prostatectomy. Literature on disease progression after radical prostatectomy (RP) is reviewed and a selection of articles made. Key words used for the Medline research included: prostate cancer (PC), RP, disease recurrence, prostate-specific antigen (PSA) progression and biochemical failure (BF). Within 10 years following RP for clinically localized PC, about 1/3 of patients will present disease recurrence. This is generally diagnosed by BF. The prognosis of these men may vary considerably. Differences in PSA kinetics (PSA doubling time, PSADT, onset of PSA rise) are useful for differentiating between local recurrence and distant disease. Indications and results are provided for different treatment strategies such as local radiation therapy, hormone therapy or watchful waiting. The present paper reviews the recent international literature. Diagnostic strategies and therapeutic manoeuvres are discussed. Prognostic factors as well as treatment indications are presented with the aim of applying an individual therapy.