Management of prostate-specific antigen relapse in prostate cancer: A European concensus Journal Article


Authors: Boccon-Gibod, L.; Djavan, B.; Hammerer, P.; Hoeltl, W.; Kattan, M. W.; Prayer-Galetti, T.; Teillac, P.; Tunn, U. W.
Article Title: Management of prostate-specific antigen relapse in prostate cancer: A European concensus
Abstract: A European Consensus on the management of prostate-specific antigen (PSA) relapse in patients with prostate cancer has been formulated. The key recommendations proposed are that total PSA is the best detection tool for prostate cancer, with free and complexed PSA having a role in the PSA range 1-4 ng/ml. PSA relapse after radical prostatectomy (RP) has been defined as a value of 0.2 ng/ml with one subsequent rise, while the ASTRO definition should be used after radiotherapy. A PSA level of less than 0.4 ng/ml after hormonal therapy can be considered an indicator of a positive response. Continuous assessment using nomograms or artificial neural networks will help to determine whether progression after local therapy is distant or local, which is the basis for treatment decisions. Secondary treatment after local failure of RP should be initiated when PSA levels reach 1.0-1.5 ng/ml and salvage radiotherapy can be considered with or without hormonal therapy. Local failure after radiotherapy can be treated with a choice of high-intensity-focused ultrasound, salvage RP (only in highly selected patients), cryotherapy or external beam radiation. Treatment of distant failure involves hormonal manipulation, the type and the timing of which is based on both physician and patient preferences. © 2004 Blackwell Publishing Ltd.
Keywords: treatment outcome; treatment failure; review; cancer recurrence; salvage therapy; cancer growth; medical decision making; prostate specific antigen; consensus; neoplasm recurrence, local; prostate cancer; europe; prostate-specific antigen; prostatic neoplasms; diagnostic value; prostatectomy; high intensity focused ultrasound; brachytherapy; hormonal therapy; antiandrogen; hydrocortisone; antineoplastic agents, hormonal; cryosurgery; artificial neural network; european consensus; beam therapy; prostate specific antigen (psa); estrogen derivative; humans; human; male; priority journal; total psa; psa relapse
Journal Title: International Journal of Clinical Practice
Volume: 58
Issue: 4
ISSN: 1368-5031
Publisher: Wiley Blackwell  
Date Published: 2004-04-01
Start Page: 382
End Page: 390
Language: English
DOI: 10.1111/j.1368-5031.2004.00184.x
PROVIDER: scopus
DOI/URL:
Notes: Int. J. Clin. Pract. -- Cited By (since 1996):63 -- Export Date: 16 June 2014 -- CODEN: IJCPF -- Source: Scopus
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  1. Michael W Kattan
    218 Kattan