Related Experiment Video
Updated: Jul 3, 2026
A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
Distant and local recurrence in patients with biochemical failure after prostate brachytherapy
Richard G Stock1, Jamie A Cesaretti, Pamela Unger
1Department of Radiation Oncology, Mount Sinai School of Medicine, 1184 5th Avenue, New York, NY 10025, USA. richard.stock@mountsinai.org
Purpose:
To analyze the patterns of failure after the brachytherapy management of localized prostate cancer.
Methods And Materials:
From 1990 to 2008, 2869 patients underwent prostate brachytherapy and 213 experienced a prostate-specific antigen (PSA) failure by the Phoenix definition. Of these 213 patients, 33.5% were low, 18.5% intermediate, and 58% high risk.
Results:
Of the 119 patients biopsied, 36 (30%) had a least one positive posttreatment biopsy. In univariate and multivariate analyses, PSA doubling time was the most predictive of a positive biopsy. Patients with doubling times < or =3, >3-6, > or =6-10, and >10 months had positive biopsy rates of 9%, 18%, 36%, and 42%, respectively (p=0.01). The actuarial rate of remaining free from distant metastases at 10 years was 73%. Patients with PSA doubling times of < or =3, >3-6, >6-10, and >10 months had freedom from distant metastases rates of 0%, 74%, 78%, and 94.5% at 10 years, respectively (p<0.0001). In multivariate analysis, PSA doubling time and time to PSA failure were the most significant predictors of developing distant metastases.
Conclusions:
About one third of patients harbor a component of local failure and one fourth demonstrate clinical metastases. PSA doubling time can be used to help predict the source of a rising PSA.
