title: [Salvage treatments following prostate radiation therapy: role of the urologist].
abstract: The management of recurrent prostate cancer after radiotherapy or brachytherapy is non-standardized and rapidly evolving. Local recurrence is observed on average in 30% of cases several years following irradiation. A key challenge is to determine the site of recurrence and imaging (MRI and PET choline) coupled to prostate biopsies are important to confirm the local character. Salvage therapy performed by the urologist can then control the situation. Radical prostatectomy subject to strict technical conditions is one of the most efficient local treatments, however it comes at the cost of significant urinary morbidity; minimally invasive therapies (focused ultrasound and cryotherapy) have also their place in specific indications. Each clinical situation should be discussed in pluridisciplinary meetings integrating the oncologic and functional status at recurrence, the risk/benefit ratio of each treatment, the patient's wishes and probability of survival.
authors.affiliation: Département d'urologie, d'andrologie et de transplantation rénale, université Paul-Sabatier, CHU Rangueil, 1, avenue Jean-Poulhès, 31403 Toulouse cedex 4, France. Electronic address: soulie.m@chu-toulouse.fr.
authors.forename: M
authors.initials: M
authors.lastname: Soulié
authors.affiliation: Service d'urologie, université de Créteil, CHU Henri-Mondor, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Salomon
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000532:radiotherapy / Q000628:therapy*; D001706:Biopsy; D003131:Combined Modality Therapy; D017679:Cryotherapy; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy; D010348:Patient Care Team; D010819:Physician's Role; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D061089:Radiotherapy, Image-Guided; D016879:Salvage Therapy; D014572:Urology
chemical_list: D017430:Prostate-Specific Antigen
keywords: Brachytherapy; Cancer de la prostate; Cryotherapy; Cryothérapie; Curiethérapie; High intensity focused ultrasound; Prostatectomie totale de rattrapage; Radiotherapy; Radiothérapie; Recurrent prostate cancer; Récidive; Salvage radical prostatectomy; Ultrasons focalisés