[Tumour recurrence].

In Chap. 6 the German S3 guideline on prostate cancer addresses the issue of tumour recurrence following primary local treatment with curative intent, i.e. after radical prostatectomy or a form of radiotherapy. PSA recurrence after radical surgery is defined as a rising PSA of 0.2 ng/ml and after radiotherapy as an increase of at least 2 ng/ml above the individual nadir. Factors for the clinical judgement that a local recurrence is likely are empirical indicators from the primary tumour diagnosis and the PSA course after primary treatment. Salvage external beam radiotherapy after radical surgery does not require the histological proof of a local recurrence and should be initiated early (PSA < 0.5 ng/ml). Before salvage radical prostatectomy, which carries a higher complication rate, the presence of a local recurrence should be histologically verified.