Biochemical recurrence after radical prostatectomy: what does it mean?

Vol. 43 (x): 2017 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2016.0656


Rafael Tourinho-Barbosa 1,2, Victor Srougi 1,3, Igor Nunes-Silva 1, Mohammed Baghdadi 1, Gregory Rembeyo 1, Sophie S. Eiffel 1, Eric Barret 1, Francois Rozet 1, Marc Galiano 1, Xavier Cathelineau 1, Rafael Sanchez-Salas 1
1 Department of Urology, Institut Montsouris, Université Paris-Descartes, Paris, France; 2 Divisão de Urologia, Faculdade de Medicina ABC, São Paulo, Brasil; 3 Divisão de Urologia, Universidade de São Paulo, São Paulo, Brasil


Background: Radical prostatectomy (RP) has been used as the main primary treatment for prostate cancer (PCa) for many years with excellent oncologic results. However, approximately 20-40% of those patients has failed to RP and presented biochemical recurrence (BCR). Prostatic specific antigen (PSA) has been the pivotal tool for recurrence diagnosis, but there is no consensus about the best PSA threshold to define BCR until this moment. The natural history of BCR after surgical procedure is highly variable, but it is important to distinguish biochemical and clinical recurrence and to find the correct timing to start multimodal treatment strategy. Also, it is important to understand the role of each clinical and pathological feature of prostate cancer in BCR, progression to metastatic disease and cancer specific mortality (CSM).

Review design: A simple review was made in Medline for articles written in English language about biochemical recurrence after radical prostatectomy.

Objective: To provide an updated assessment of BCR definition, its meaning, PCa natural history after BCR and the weight of each clinical/pathological feature and risk group classifications in BCR, metastatic disease and CSM.


Keywords: Prostatic Neoplasms; Prostate-Specific Antigen; Prostatectomy

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