Augustin H, Hammerer P G
Department of Urology, Karl-Franzens-University, Graz, Austria.
Minerva Urol Nefrol. 2003 Dec;55(4):251-61.
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.
在本文中，作者概述了根治性前列腺切除术后疾病复发患者的当代诊断和治疗策略。回顾了关于根治性前列腺切除术（RP）后疾病进展的文献并选取了一些文章。用于医学文献数据库（Medline）检索的关键词包括：前列腺癌（PC）、RP、疾病复发、前列腺特异性抗原（PSA）进展和生化复发（BF）。对于临床局限性前列腺癌患者，在RP后的10年内，约1/3的患者会出现疾病复发。这通常通过生化复发来诊断。这些男性的预后可能差异很大。PSA动力学差异（PSA倍增时间、PSADT、PSA开始升高）有助于区分局部复发和远处疾病。文中提供了不同治疗策略（如局部放疗、激素治疗或观察等待）的适应证和结果。本文回顾了近期的国际文献。讨论了诊断策略和治疗手段。为了实施个体化治疗，还介绍了预后因素以及治疗适应证。
