Hakenberg O W, Sedlmayer F
Urologische Universitäts-Klinik und Poliklinik, Ernst-Heydemann-Strasse 6, 18055 Rostock.
Urologe A. 2010 Feb;49(2):228-32. doi: 10.1007/s00120-010-2239-2.
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.
在第6章中，德国前列腺癌S3指南讨论了以治愈为目的的原发性局部治疗后肿瘤复发的问题，即根治性前列腺切除术后或某种形式的放射治疗后。根治性手术后PSA复发定义为PSA升高0.2 ng/ml，放射治疗后定义为高于个体最低点至少2 ng/ml。判断局部复发可能性的临床因素是来自原发性肿瘤诊断和初次治疗后PSA病程的经验性指标。根治性手术后挽救性外照射放疗不需要局部复发的组织学证据，应尽早开始（PSA<0.5 ng/ml）。在具有较高并发症发生率的挽救性根治性前列腺切除术之前，应通过组织学证实局部复发的存在。
