Treatment options for localized recurrence of prostate cancer following radiation therapy

The Urologic Clinics of North America
D A CorralA C von Eschenbach

Abstract

Patients with radioresistant clinically localized prostate cancer may be treated by various means. Although androgen ablation is relatively noninvasive, it cannot be considered a curative option. We believe that a subset of patients with locally recurrent prostate cancer without subclinical metastatic disease exists and would benefit from maximally aggressive local therapy. Salvage surgery may offer long-term cancer control, particularly when the tumor is organ-confined, but is a technically challenging operation with a high incidence of postoperative incontinence. Cryoablation of the prostate for postirradiation recurrence may offer a less invasive alternative to radical surgery, but its long-term efficacy remains to be fully determined. Each therapeutic option has its characteristic attendant morbidity and the choice of therapy for local recurrence should be made with informed consent after frank discussion between physician and patient. We propose the treatment algorithm shown in Figure 1 for the management of patients with suspected recurrence after radiation therapy with the caveat that individual therapeutic strategies must be patterned around individual patient needs.

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Citations

Sep 4, 1999·In Vitro Cellular & Developmental Biology. Animal·J E Kalns, E H Piepmeier
May 9, 2003·The Urologic Clinics of North America·Nancy B DavisNicholas J Vogelzang
Jun 29, 2005·Prostate Cancer and Prostatic Diseases·B J DonnellyJ Rewcastle
Nov 30, 2005·Prostate Cancer and Prostatic Diseases·V MouravievT J Polascik
Mar 26, 2004·Clinical Prostate Cancer·Duke K BahnJohn C Rewcastle
May 27, 2004·International Journal of Clinical Practice·L Boccon-GibodU W Tunn
May 14, 2005·International Journal of Radiation Oncology, Biology, Physics·Fernando J BiancoJames A Eastham
Oct 10, 2001·The Urologic Clinics of North America·B ShekarrizJ E Pontes
Dec 19, 2003·The Urologic Clinics of North America·Eric M HorwitzDan Theodorescu
Sep 28, 2002·The Journal of Urology·Timothy R NathanStephen G Bown
Mar 31, 2004·BJU International·J ReesR Persad
May 1, 2001·International Journal of Urology : Official Journal of the Japanese Urological Association·Y FuruyaH Ito

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