«Salvage» Therapy Methods after Radical Prostatectomy

Sivkov A.V., Murav'ev V., Keshishev N.G., Shaderkin I.A., Shkabko O.V.

Currently, there is increasing incidence of prostate cancer and the percentage of detection of the disease in the early stages of the disease, which allows us to apply the radical methods of treatment. But there is a certain percentage of local recurrence of the disease after radical treatment that requires salvage therapy for prostate cancer. Objective: To determine local recurrence after radical treatment of prostate cancer, to identify diagnostic algorithm of local recurrence, to choose options of local recurrence of prostate cancer (PCa) management. Materials and methods: Publications on results of radical prostatectomy (RPE), radiation therapy, HIFU and cryoablation as a salvage option after RPE were analyzed. Results: Criteria for differentiation of local recurrence from general: after surgery PSA growth time, PSA increment velocity, stage and Gleason sum. For local recurrence confirmation urethrovesical anastomosis suspicious areas biopsy is recommended. Following salvage options were analyzed: salvage beam therapy (sBTh), salvage radical prostatectomy (sRPE), salvage high dose brachytherapy (sHDBTh) and salvage cryotherapy (sCTh). Resume: In local recurrence after RPE sBTh seems more reasonable, HIFU and cryoablation are promising techniques. In local recurrence after beam therapy sRPE is scientifically proven option. Ablative methods and sHDBTh are promising techniques, but more long-term results are needed. In local recurrence after brachytherapy sRPE, sHDBTh and HIFU are possible. Long-term results and more experience are required.

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