[Local recurrence after radical prostatectomy and salvage radiotherapy].
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.
Ojea Calvo
Antonio
A
Servicio de Urología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España. dr.ojea@telefonica.net
Pérez Rodríguez
Alberto
A
Domínguez Freire
Fernando
F
Alonso Rodrigo
Arturo
A
Rodríguez Iglesias
Benito
B
Benavente Delgado
Juan
J
Barros Rodríguez
José Manuel
JM
González Piñeiro
Ana
A
Otero García
Milagros
M
Muñoz Garzón
Víctor
V
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