Very late local recurrence after surgery for prostate cancer unaccompanied by detectable PSA levels.
The possibility and possible aetiology of local prostate cancer (PC) recurrence despite undetectable prostate-specific antigen (PSA) levels are highlighted. A case of a local recurrence 8.5 years after radical prostatectomy for Gleason 3+4 PC is presented. It demonstrates that PC can recur, even after a prolonged period of time (8.5 years), despite undetectable levels (i.e. <0.02 ng/ml) of PSA. In conclusion, the decision to omit digital rectal examination from the follow-up regimens of men with undetectable PSA levels could be justified. In such exceptional cases, however, PC recurrence would be either missed or would only be diagnosed after a considerable delay.
Roemeling
S
S
Department of Urology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. s.roemeling@erasmusmc.nl
van Leenders
G J L H
GJ
Schröder
F H
FH
D000368:Aged; D001707:Biopsy, Needle; D001918:Brachytherapy / Q000379:methods; D019160:Endosonography / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000473:pathology* / Q000532:radiotherapy; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D018570:Risk Assessment; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014555:Urination Disorders / Q000175:diagnosis / Q000209:etiology
D017430:Prostate-Specific Antigen