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A Journal on Nephrology and Urology

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Minerva Urologica e Nefrologica 2003 December;55(4):251-61

language: English

Disease recurrence after radical prostatectomy. Contemporary diagnostic and therapeutical strategies

Augustin H. 1, Hammerer P. G. 2

1 Department of Urology Karl-Franzens-University, Graz, Austria
2 Department of Urology Hospital of Braunschweig Braunschweig, Germany


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.

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