Department of Urology, Institut Montsouris, Université Paris-Descartes, Paris, France.
Divisão de Urologia, Faculdade de Medicina ABC, São Paulo, Brasil.
Int Braz J Urol. 2018 Jan-Feb;44(1):14-21. doi: 10.1590/S1677-5538.IBJU.2016.0656.
Radical prostatectomy (RP) has been used as the main primary treatment for prostate cancer (PCa) for many years with excellent oncologic results. However, approximately 20-40% of those patients has failed to RP and presented biochemical recurrence (BCR). Prostatic specific antigen (PSA) has been the pivotal tool for recurrence diagnosis, but there is no consensus about the best PSA threshold to define BCR until this moment. The natural history of BCR after surgical procedure is highly variable, but it is important to distinguish biochemical and clinical recurrence and to find the correct timing to start multimodal treatment strategy. Also, it is important to understand the role of each clinical and pathological feature of prostate cancer in BCR, progression to metastatic disease and cancer specific mortality (CSM). Review design: A simple review was made in Medline for articles written in English language about biochemical recurrence after radical prostatectomy.
To provide an updated assessment of BCR definition, its meaning, PCa natural history after BCR and the weight of each clinical/pathological feature and risk group classifications in BCR, metastatic disease and CSM.
根治性前列腺切除术（RP）多年来一直被用作前列腺癌（PCa）的主要初始治疗方法，具有出色的肿瘤学结果。然而，大约 20-40%的患者未能接受 RP 治疗，出现生化复发（BCR）。前列腺特异性抗原（PSA）一直是复发诊断的关键工具，但直到目前为止，尚无关于定义 BCR 的最佳 PSA 阈值的共识。手术治疗后 BCR 的自然史变化很大，但区分生化和临床复发并找到开始多模式治疗策略的正确时机很重要。此外，了解前列腺癌的每个临床和病理特征在 BCR、进展为转移性疾病和癌症特异性死亡率（CSM）中的作用也很重要。
在 Medline 上检索了有关 RP 后生化复发的英文文献，并进行了简单的综述。
提供对 BCR 定义、其意义、BCR 后 PCa 自然史以及 BCR、转移性疾病和 CSM 中每个临床/病理特征和风险组分类的权重的最新评估。
