UroToday- Dr. Dudderidge and colleagues at the University College London, England propose in the online version of BJU International an algorithm to manage prostate cancer (CaP) recurrence following radiotherapy (XRT).

This report is based upon the authors' review of relevant literature and their personal experience. They propose a surveillance plan for patients who underwent XRT for CaP with curative intent. An initial PSA at 6 weeks then every 3 months until a stable PSA nadir is reached. At that point PSA should be followed every 6 months. If the PSA begins to raise it should be followed again at 3 monthly intervals but if not then beginning at 5 years it can be checked annually.

They advocate the Phoenix definition of PSA failure, which is the PSA nadir plus 2ng/ml. In those with recurrence and contemplating salvage therapy a prostate biopsy should be performed. Staging should be performed using contrast enhanced dynamic MRI of the prostate. The authors reviewed the Prostascint scan but based upon their interpretation of the literature did not favor it.

For high risk cases (PSA >10ng/ml, Gleason score >7, PSADT 10ng/ml, Gleason score >8, and PSADT

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