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KMID : 1001020110090030099
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Korean Journal of Urological Oncology
2011 Volume.9 No. 3 p.99 ~ p.103
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Management of Biochemical Recurrence after Curative Treatment in Localized Prostate Cancer: Androgen Deprivation Therapy or Surveillance
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Yang Won-Jae
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Abstract
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With approximately 220,000 cases of prostate cancer (PCa) diagnosed each year in the United States, two-thirds of which are treated with surgery or radiation therapy (RT), and with as many as 40% of patients eventually experiencing disease relapse, a prostate-specific antigen (PSA) only early progression up to 60,000 men per year. Clinicians evaluating patients with biochemical recurrence (BCR) following radical prostatectomy (RP) or RT are faced with the significant challenge of determining whether there is evidence of local vs. systemic relapse. Androgen deprivation therapy (ADT) is commonly used for the management of PSA only recurrence. However, to date there is little published literature supporting this intervention in the clinical setting. There is evidence that earlier initiation of ADT can decrease mortality and disease progression in men who had early recurrence and other high-risk disease characteristics, but this has to be balanced out with disadvantages of important toxicity and costs. Natural history of patients presenting BCR after curative treatment revealed "good risk PCa patients with a BCR" are indeed really good-risk ones. Only a minority of men experience systemic progression and death from PCa following curative treatment.
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KEYWORD
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Prostate cancer, Biochemical recurrence, Androgen deprivation therapy, Surveillance
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