Review article Salvage surgery for locally recurrent prostate cancer after radiation therapy

Controversy exists regarding the optimal management of patients with an asymptomatic rising prostate specific antigen (PSA) level and locally recurrent adenocarcinoma of the prostate following definitive radiation therapy. Several treatment options may be offered in this clinical scenario, including salvage surgery, cryotherapy, watchful waiting, or androgen deprivation. Postradiation therapy patients whose residual disease is localized to the prostate may benefit from salvage surgery. Indeed, among all available options, only salvage surgery has been shown to result in long-term disease-free survival. However, treatment must be individualized according to clinical stage, serum PSA level before radiation and surgery, the medical condition of the patient, and expectations of the physician and patient. Herein, we review the available literature and our own experience with salvage surgery for radio-recurrent prostate cancer.