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Salvage Treatment for Recurrent Prostate Cancer Following Brachytherapy: For Whom, When and Which?

Abstract

Brachytherapy to treat prostate carcinoma can be given either as permanent LDR seed implantation or as temporary HDR brachytherapy. Biochemical failure rate following brachytherapy is difficult to define. Multiple clinical characteristics have been described, and mostly the biochemical failure definition of a PSA rise by 2 ng/mL or more above the nadir is used. Local salvage curative therapy may be considered in a patient with a good performance status if a local recurrence is documented by prostate biopsy, with no evidence of disseminated disease and a life expectancy >10 years. The morbidity for the therapeutic salvage options can be significant. The different salvage treatments are surgery, radiotherapy or minimally invasive procedures, and also a conservative management with or without hormonal treatment can be considered. The salvage radical prostatectomy is the preferred treatment for motivated patients that accept the significant morbidity. Salvage brachytherapy seems to be a good alternative. The minimally invasive treatment modalities should be considered investigational in this setting. Optimal salvage hormonal timing still has to be defined but resulted in improved overall survival.

Keywords

  • Radical Prostatectomy
  • Biochemical Recurrence
  • Urethral Stricture
  • Biochemical Failure
  • Artificial Urinary Sphincter

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Fig. 19.1

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Correspondence to Theo M. de Reijke MD, PhD, FEBU .

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Stuurman-Wieringa, R.E., Sodha, H.S., Gravas, S., de la Rosette, J.J.M.H.C., de Reijke, T.M. (2013). Salvage Treatment for Recurrent Prostate Cancer Following Brachytherapy: For Whom, When and Which?. In: Kovács, G., Hoskin, P. (eds) Interstitial Prostate Brachytherapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36499-0_19

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