title: [Local recurrence after radical prostatectomy and salvage radiotherapy].
abstract: OBJECTIVE
  To evaluate the efficacy of radiotherapy to the prostatic bed in patients with biochemical recurrence prostate cancer after radical prostatectomy.
  
  
  METHODS
  We analyse the outcomes of 292 patients who underwent radical prostatectomy for localized prostate cancer T1-T2 between January 1992 and June 2003, with an average follow-up of 36 months (range 6 months to 12 years). We detected biochemical recurrence (PSA > 0.20 ng/ml) in 75 (26%) patients. 75 patients with biochemical recurrence, 9 (12%) were diagnosed of local recurrence by the following criteria: a) First PSA obtained 6 weeks after radical prostatectomy < 0.20 ng/ml. b) Time to biochemical recurrence > 6 months. c) Prostate specific antigen doubling time > 6 months. d) Prostate specific antigen velocity after radical prostatectomy < 0.75 ng/ml/year. e) Prostate specific antigen level after radical prostatectomy < 2.5 ng/ml. The 9 patients diagnosed of local recurrence received an average dose of 56.42 Gy to the prostate bed.
  
  
  RESULTS
  Of all 9 patients with local recurrence, 8(88.8%) have complete response with a mean follow-up of 30 months (12-36 months). The time between the radiotherapy and the response, in patients with complete response, was lower than 3 months in 7 patients and 12 months in 1 patient. Significant adverse effects associated to radiotherapy were not observed.
  
  
  CONCLUSIONS
  Salvage radiotherapy may be beneficial in selected patients with local recurrence. The characteristics of prostate specific antigen elevation are useful in distinguishing men with local recurrence from those with distant metastases.
authors.affiliation: Servicio de Urología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España. dr.ojea@telefonica.net
authors.forename: Antonio
authors.initials: A
authors.lastname: Ojea Calvo
authors.forename: Alberto
authors.initials: A
authors.lastname: Pérez Rodríguez
authors.forename: Fernando
authors.initials: F
authors.lastname: Domínguez Freire
authors.forename: Arturo
authors.initials: A
authors.lastname: Alonso Rodrigo
authors.forename: Benito
authors.initials: B
authors.lastname: Rodríguez Iglesias
authors.forename: Juan
authors.initials: J
authors.lastname: Benavente Delgado
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Barros Rodríguez
authors.forename: Ana
authors.initials: A
authors.lastname: González Piñeiro
authors.forename: Milagros
authors.initials: M
authors.lastname: Otero García
authors.forename: Víctor
authors.initials: V
authors.lastname: Muñoz Garzón
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D016879:Salvage Therapy; D017211:Treatment Failure