Advertisement

Management of Nonmetastatic Failure Following Local Prostate Cancer Therapy

  • David Ambuehl
  • Silvan Boxler
  • George Thalmann
  • Martin Spahn
Living reference work entry

Abstract

Biochemical recurrence (BCR) following curative surgery or radiation therapy in men with localized prostate cancer (PCa) is a common occurrence and one of the most challenging situations in urological oncology. Local recurrence or metastatic disease can be the underlying cause of rising prostate-specific antigen (PSA). The clinical course in these patients is highly variable, some patients requiring only observation, others needing local and/or systemic treatment. The decision to treat depends on various factors, including previous treatment, site of recurrence, individual tumor-specific parameters, PSA kinetics, comorbidities, and individual patient considerations. Observation is indicated in men with a favorable risk profile, elderly patients, or patients with severe comorbidities. Salvage radiation therapy and salvage prostatectomy are the preferred curative treatment options for men with local recurrence. Treatment should be based on the individual patient’s history and selected after careful discussion in a multidisciplinary team to minimize treatment related side effects.

Keywords

Prostate cancer Nonmetastatic failure Biochemical recurrence Rising PSA Salvage radiation therapy Salvage radical prostatectomy Salvage pelvic lymph node dissection Salvage brachytherapy Salvage HIFU 

References

  1. Ahmad I, Kalna G, Ismail M, Birrell F, Asterling S, McCartney E, et al. Prostate gland lengths and iceball dimensions predict micturition functional outcome following salvage prostate cryotherapy in men with radiation recurrent prostate cancer. PLoS One. 2013;8(8):e69243.CrossRefGoogle Scholar
  2. Ahmed HU, Cathcart P, McCartan N, Kirkham A, Allen C, Freeman A, et al. Focal salvage therapy for localized prostate cancer recurrence after external beam radiotherapy: a pilot study. Cancer. 2012;118(17):4148–55.CrossRefGoogle Scholar
  3. American Society for Therapeutic Radiology and Oncology Consensus Panel. Consensus statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys. 1997;37(5):1035–41.Google Scholar
  4. Aus G. Current status of HIFU and cryotherapy in prostate cancer – a review. Eur Urol. 2006;50(5):927–34; discussion 34CrossRefGoogle Scholar
  5. Beresford MJ, Gillatt D, Benson RJ, Ajithkumar T. A systematic review of the role of imaging before salvage radiotherapy for post-prostatectomy biochemical recurrence. Clin Oncol. 2010;22(1):46–55.CrossRefGoogle Scholar
  6. Boccon-Gibod L, Djavan WB, Hammerer P, Hoeltl W, Kattan MW, Prayer-Galetti T, et al. Management of prostate-specific antigen relapse in prostate cancer: a European Consensus. Int J Clin Pract. 2004;58(4):382–90.CrossRefGoogle Scholar
  7. Bolla M, van Poppel H, Collette L, van Cangh P, Vekemans K, Da Pozzo L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet. 2005;366(9485):572–8.CrossRefGoogle Scholar
  8. Boorjian SA, Thompson RH, Tollefson MK, Rangel LJ, Bergstralh EJ, Blute ML, et al. Long-term risk of clinical progression after biochemical recurrence following radical prostatectomy: the impact of time from surgery to recurrence. Eur Urol. 2011;59(6):893–9.CrossRefGoogle Scholar
  9. Briganti A, Wiegel T, Joniau S, Cozzarini C, Bianchi M, Sun M, et al. Early salvage radiation therapy does not compromise cancer control in patients with pT3N0 prostate cancer after radical prostatectomy: results of a match-controlled multi-institutional analysis. Eur Urol. 2012;62(3):472–87.CrossRefGoogle Scholar
  10. Brockman JA, Alanee S, Vickers AJ, Scardino PT, Wood DP, Kibel AS, et al. Nomogram predicting prostate cancer-specific mortality for men with biochemical recurrence after radical prostatectomy. Eur Urol. 2015;67(6):1160–7.CrossRefGoogle Scholar
  11. Burri RJ, Stone NN, Unger P, Stock RG. Long-term outcome and toxicity of salvage brachytherapy for local failure after initial radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2010;77(5):1338–44.CrossRefGoogle Scholar
  12. Calabria F, Rubello D, Schillaci O. The optimal timing to perform 18F/11C-choline PET/CT in patients with suspicion of relapse of prostate cancer: trigger PSA versus PSA velocity and PSA doubling time. Int J Biol Markers. 2014;29(4):e423–30.CrossRefGoogle Scholar
  13. Carrie C, Hasbini A, de Laroche G, Richaud P, Guerif S, Latorzeff I, et al. Salvage radiotherapy with or without short-term hormone therapy for rising prostate-specific antigen concentration after radical prostatectomy (GETUG-AFU 16): a randomised, multicentre, open-label phase 3 trial. Lancet Oncol. 2016;17(6):747–56.CrossRefGoogle Scholar
  14. Cella DF, Mahon SM, Donovan MI. Cancer recurrence as a traumatic event. Behav Med. 1990;16(1):15–22.CrossRefGoogle Scholar
  15. Cespedes RD, Pisters LL, von Eschenbach AC, McGuire EJ. Long-term followup of incontinence and obstruction after salvage cryosurgical ablation of the prostate: results in 143 patients. J Urol. 1997;157(1):237–40.CrossRefGoogle Scholar
  16. Chade DC, Eastham J, Graefen M, Hu JC, Karnes RJ, Klotz L, et al. Cancer control and functional outcomes of salvage radical prostatectomy for radiation-recurrent prostate cancer: a systematic review of the literature. Eur Urol. 2012;61(5):961–71.CrossRefGoogle Scholar
  17. Chen CP, Weinberg V, Shinohara K, Roach M III, Nash M, Gottschalk A, et al. Salvage HDR brachytherapy for recurrent prostate cancer after previous definitive radiation therapy: 5-year outcomes. Int J Radiat Oncol Biol Phys. 2013;86(2):324–9.CrossRefGoogle Scholar
  18. Cirillo S, Petracchini M, Scotti L, Gallo T, Macera A, Bona MC, et al. Endorectal magnetic resonance imaging at 1.5 Tesla to assess local recurrence following radical prostatectomy using T2-weighted and contrast-enhanced imaging. Eur Radiol. 2009;19(3):761–9.CrossRefGoogle Scholar
  19. Cornford P, Bellmunt J, Bolla M, Briers E, De Santis M, Gross T, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part II: treatment of relapsing, metastatic, and castration-resistant prostate cancer. Eur Urol. 2017;71(4):630–42.CrossRefGoogle Scholar
  20. Crook JM, O’Callaghan CJ, Duncan G, Dearnaley DP, Higano CS, Horwitz EM, et al. Intermittent androgen suppression for rising PSA level after radiotherapy. N Engl J Med. 2012;367(10):895–903.CrossRefGoogle Scholar
  21. Denham JW, Steigler A, Wilcox C, Lamb DS, Joseph D, Atkinson C, et al. Time to biochemical failure and prostate-specific antigen doubling time as surrogates for prostate cancer-specific mortality: evidence from the TROG 96.01 randomised controlled trial. Lancet Oncol. 2008;9(11):1058–68.CrossRefGoogle Scholar
  22. Deo DD, Rao AP, Bose SS, Ouhtit A, Baliga SB, Rao SA, et al. Differential effects of leptin on the invasive potential of androgen-dependent and -independent prostate carcinoma cells. J Biomed Biotechnol. 2008;2008:163902.CrossRefGoogle Scholar
  23. Duchesne GM, Woo HH, Bassett JK, Bowe SJ, D’Este C, Frydenberg M, et al. Timing of androgen-deprivation therapy in patients with prostate cancer with a rising PSA (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial. Lancet Oncol. 2016;17(6):727–37.CrossRefGoogle Scholar
  24. Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Dorey FJ, Walsh PC, et al. Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA. 2005;294(4):433–9.CrossRefGoogle Scholar
  25. Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Dorey FJ, Walsh PC, et al. Death in patients with recurrent prostate cancer after radical prostatectomy: prostate-specific antigen doubling time subgroups and their associated contributions to all-cause mortality. J Clin Oncol. 2007;25(13):1765–71.CrossRefGoogle Scholar
  26. Grimm P, Billiet I, Bostwick D, Dicker AP, Frank S, Immerzeel J, et al. Comparative analysis of prostate-specific antigen free survival outcomes for patients with low, intermediate and high risk prostate cancer treatment by radical therapy. Results from the Prostate Cancer Results Study Group. BJU Int. 2012;109(Suppl 1):22–9.CrossRefGoogle Scholar
  27. Grossfeld GD, Li YP, Lubeck DP, Broering JM, Mehta SS, Carroll PR. Predictors of secondary cancer treatment in patients receiving local therapy for prostate cancer: data from cancer of the prostate strategic urologic research endeavor. J Urol. 2002;168(2):530–5.CrossRefGoogle Scholar
  28. Hamdy FC, Donovan JL, Lane JA, Mason M, Metcalfe C, Holding P, et al. 10-Year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med. 2016;375(15):1415–24.CrossRefGoogle Scholar
  29. Heidenreich A, Semrau R, Thuer D, Pfister D. Radical salvage prostatectomy: treatment of local recurrence of prostate cancer after radiotherapy. Urologe A. 2008;47(11):1441–6.CrossRefGoogle Scholar
  30. Horwitz EM, Thames HD, Kuban DA, Levy LB, Kupelian PA, Martinez AA, et al. Definitions of biochemical failure that best predict clinical failure in patients with prostate cancer treated with external beam radiation alone: a multi-institutional pooled analysis. J Urol. 2005;173(3):797–802.CrossRefGoogle Scholar
  31. Karnes RJ, Murphy CR, Bergstralh EJ, DiMonte G, Cheville JC, Lowe VJ, et al. Salvage lymph node dissection for prostate cancer nodal recurrence detected by 11C-choline positron emission tomography/computerized tomography. J Urol. 2015;193(1):111–6.CrossRefGoogle Scholar
  32. King CR. The timing of salvage radiotherapy after radical prostatectomy: a systematic review. Int J Radiat Oncol Biol Phys. 2012;84(1):104–11.CrossRefGoogle Scholar
  33. Kitajima K, Murphy RC, Nathan MA, Froemming AT, Hagen CE, Takahashi N, et al. Detection of recurrent prostate cancer after radical prostatectomy: comparison of 11C-choline PET/CT with pelvic multiparametric MR imaging with endorectal coil. J Nucl Med. 2014;55(2):223–32.CrossRefGoogle Scholar
  34. Lange PH, Ercole CJ, Lightner DJ, Fraley EE, Vessella R. The value of serum prostate specific antigen determinations before and after radical prostatectomy. J Urol. 1989;141(4):873–9.CrossRefGoogle Scholar
  35. Lee WR, Hanks GE, Hanlon A. Increasing prostate-specific antigen profile following definitive radiation therapy for localized prostate cancer: clinical observations. J Clin Oncol. 1997;15(1):230–8.CrossRefGoogle Scholar
  36. Liauw SL, Pitroda SP, Eggener SE, Stadler WM, Pelizzari CA, Vannier MW, et al. Evaluation of the prostate bed for local recurrence after radical prostatectomy using endorectal magnetic resonance imaging. Int J Radiat Oncol Biol Phys. 2013;85(2):378–84.CrossRefGoogle Scholar
  37. Linder BJ, Kawashima A, Woodrum DA, Tollefson MK, Karnes J, Davis BJ, et al. Early localization of recurrent prostate cancer after prostatectomy by endorectal coil magnetic resonance imaging. Can J Urol. 2014;21(3):7283–9.PubMedGoogle Scholar
  38. Moul JW. Prostate specific antigen only progression of prostate cancer. J Urol. 2000;163(6):1632–42.CrossRefGoogle Scholar
  39. Oefelein MG, Smith N, Carter M, Dalton D, Schaeffer A. The incidence of prostate cancer progression with undetectable serum prostate specific antigen in a series of 394 radical prostatectomies. J Urol. 1995;154(6):2128–31.CrossRefGoogle Scholar
  40. Oesterling JE, Chan DW, Epstein JI, Kimball AW Jr, Bruzek DJ, Rock RC, et al. Prostate specific antigen in the preoperative and postoperative evaluation of localized prostatic cancer treated with radical prostatectomy. J Urol. 1988;139(4):766–72.CrossRefGoogle Scholar
  41. O’Farrell S, Garmo H, Holmberg L, Adolfsson J, Stattin P, Van Hemelrijck M. Risk and timing of cardiovascular disease after androgen-deprivation therapy in men with prostate cancer. J Clin Oncol. 2015;33(11):1243–51.CrossRefGoogle Scholar
  42. Ohri N, Dicker AP, Trabulsi EJ, Showalter TN. Can early implementation of salvage radiotherapy for prostate cancer improve the therapeutic ratio? A systematic review and regression meta-analysis with radiobiological modelling. Eur J Cancer. 2012;48(6):837–44.CrossRefGoogle Scholar
  43. Ost P, Lumen N, Goessaert AS, Fonteyne V, De Troyer B, Jacobs F, et al. High-dose salvage intensity-modulated radiotherapy with or without androgen deprivation after radical prostatectomy for rising or persisting prostate-specific antigen: 5-year results. Eur Urol. 2011;60(4):842–9.CrossRefGoogle Scholar
  44. Ost P, Jereczek-Fossa BA, As NV, Zilli T, Muacevic A, Olivier K, et al. Progression-free survival following stereotactic body radiotherapy for oligometastatic prostate cancer treatment-naive recurrence: a multi-institutional analysis. Eur Urol. 2016;69(1):9–12.CrossRefGoogle Scholar
  45. Partin AW, Pearson JD, Landis PK, Carter HB, Pound CR, Clemens JQ, et al. Evaluation of serum prostate-specific antigen velocity after radical prostatectomy to distinguish local recurrence from distant metastases. Urology. 1994;43(5):649–59.CrossRefGoogle Scholar
  46. Perera M, Papa N, Christidis D, Wetherell D, Hofman MS, Murphy DG, et al. Sensitivity, specificity, and predictors of positive 68Ga-prostate-specific membrane antigen positron emission tomography in advanced prostate cancer: a systematic review and meta-analysis. Eur Urol. 2016;70(6):926–37.CrossRefGoogle Scholar
  47. Pinover WH, Horwitz EM, Hanlon AL, Uzzo RG, Hanks GE. Validation of a treatment policy for patients with prostate specific antigen failure after three-dimensional conformal prostate radiation therapy. Cancer. 2003;97(4):1127–33.CrossRefGoogle Scholar
  48. Pisters LL, Rewcastle JC, Donnelly BJ, Lugnani FM, Katz AE, Jones JS. Salvage prostate cryoablation: initial results from the cryo on-line data registry. J Urol. 2008;180(2):559–63; discussion 63–4CrossRefGoogle Scholar
  49. Pisters LL, Leibovici D, Blute M, Zincke H, Sebo TJ, Slezak JM, et al. Locally recurrent prostate cancer after initial radiation therapy: a comparison of salvage radical prostatectomy versus cryotherapy. J Urol. 2009;182(2):517–25; discussion 25–7CrossRefGoogle Scholar
  50. Ploussard G, Almeras C, Briganti A, Giannarini G, Hennequin C, Ost P, et al. Management of node only recurrence after primary local treatment for prostate cancer: a systematic review of the literature. J Urol. 2015;194(4):983–8.CrossRefGoogle Scholar
  51. Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA. 1999;281(17):1591–7.CrossRefGoogle Scholar
  52. Ray ME, Thames HD, Levy LB, Horwitz EM, Kupelian PA, Martinez AA, et al. PSA nadir predicts biochemical and distant failures after external beam radiotherapy for prostate cancer: a multi-institutional analysis. Int J Radiat Oncol Biol Phys. 2006;64(4):1140–50.CrossRefGoogle Scholar
  53. Riedinger JM, Eche N, Bachaud JM, Crehange G, Fulla Y, Thuillier F. PSA kinetics after radiotherapy. Ann Biol Clin. 2009;67(4):395–404.Google Scholar
  54. Roach M III, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006;65(4):965–74.CrossRefGoogle Scholar
  55. Robertson NL, Sala E, Benz M, Landa J, Scardino P, Scher HI, et al. Combined whole body and multiparametric prostate magnetic resonance imaging as a 1-step approach to the simultaneous assessment of local recurrence and metastatic disease after radical prostatectomy. J Urol. 2017;198(1):65–70.CrossRefGoogle Scholar
  56. Rouviere O, Vitry T, Lyonnet D. Imaging of prostate cancer local recurrences: why and how? Eur Radiol. 2010;20(5):1254–66.CrossRefGoogle Scholar
  57. Shipley WU, Seiferheld W, Lukka HR, Major PP, Heney NM, Grignon DJ, et al. Radiation with or without antiandrogen therapy in recurrent prostate cancer. N Engl J Med. 2017;376(5):417–28.CrossRefGoogle Scholar
  58. Spahn M, Joniau S, Gontero P, Fieuws S, Marchioro G, Tombal B, et al. Outcome predictors of radical prostatectomy in patients with prostate-specific antigen greater than 20 ng/ml: a European multi-institutional study of 712 patients. Eur Urol. 2010;58(1):1–7; discussion 10–1CrossRefGoogle Scholar
  59. Spiess PE, Katz AE, Chin JL, Bahn D, Cohen JK, Shinohara K, et al. A pretreatment nomogram predicting biochemical failure after salvage cryotherapy for locally recurrent prostate cancer. BJU Int. 2010;106(2):194–8.CrossRefGoogle Scholar
  60. Stamey TA, Kabalin JN, McNeal JE, Johnstone IM, Freiha F, Redwine EA, et al. Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. II. Radical prostatectomy treated patients. J Urol. 1989;141(5):1076–83.CrossRefGoogle Scholar
  61. Stephenson AJ, Kattan MW, Eastham JA, Dotan ZA, Bianco FJ Jr, Lilja H, et al. Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition. J Clin Oncol. 2006;24(24):3973–8.CrossRefGoogle Scholar
  62. Stephenson AJ, Scardino PT, Kattan MW, Pisansky TM, Slawin KM, Klein EA, et al. Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. J Clin Oncol. 2007;25(15):2035–41.CrossRefGoogle Scholar
  63. Thompson IM, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D, et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol. 2009;181(3):956–62.CrossRefGoogle Scholar
  64. Tilki D, Mandel P, Seeliger F, Kretschmer A, Karl A, Ergun S, et al. Salvage lymph node dissection for nodal recurrence of prostate cancer after radical prostatectomy. J Urol. 2015;193(2):484–90.CrossRefGoogle Scholar
  65. Trapasso JG, de Kernion JB, Smith RB, Dorey F. The incidence and significance of detectable levels of serum prostate specific antigen after radical prostatectomy. J Urol. 1994;152(5 Pt 2):1821–5.CrossRefGoogle Scholar
  66. Uchida T, Shoji S, Nakano M, Hongo S, Nitta M, Usui Y, et al. High-intensity focused ultrasound as salvage therapy for patients with recurrent prostate cancer after external beam radiation, brachytherapy or proton therapy. BJU Int. 2011;107(3):378–82.CrossRefGoogle Scholar
  67. Valicenti RK, Thompson I Jr, Albertsen P, Davis BJ, Goldenberg SL, Wolf JS, et al. Adjuvant and salvage radiation therapy after prostatectomy: American Society for Radiation Oncology/American Urological Association guidelines. Int J Radiat Oncol Biol Phys. 2013;86(5):822–8.CrossRefGoogle Scholar
  68. van den Bergh RC, van Casteren NJ, van den Broeck T, Fordyce ER, Gietzmann WK, Stewart F, et al. Role of hormonal treatment in prostate cancer patients with nonmetastatic disease recurrence after local curative treatment: a systematic review. Eur Urol. 2016;69(5):802–20.CrossRefGoogle Scholar
  69. Wilt TJ, Brawer MK, Jones KM, Barry MJ, Aronson WJ, Fox S, et al. Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med. 2012;367(3):203–13.CrossRefGoogle Scholar
  70. Winter A, Henke RP, Wawroschek F. Targeted salvage lymphadenectomy in patients treated with radical prostatectomy with biochemical recurrence: complete biochemical response without adjuvant therapy in patients with low volume lymph node recurrence over a long-term follow-up. BMC Urol. 2015;15:10.CrossRefGoogle Scholar
  71. Yamada Y, Kollmeier MA, Pei X, Kan CC, Cohen GN, Donat SM, et al. A phase II study of salvage high-dose-rate brachytherapy for the treatment of locally recurrent prostate cancer after definitive external beam radiotherapy. Brachytherapy. 2014;13(2):111–6.CrossRefGoogle Scholar
  72. Yossepowitch O, Eggener SE, Bianco FJ Jr, Carver BS, Serio A, Scardino PT, et al. Radical prostatectomy for clinically localized, high risk prostate cancer: critical analysis of risk assessment methods. J Urol. 2007;178(2):493–9; discussion 9CrossRefGoogle Scholar
  73. Zumsteg ZS, Spratt DE, Romesser PB, Pei X, Zhang Z, Polkinghorn W, et al. The natural history and predictors of outcome following biochemical relapse in the dose escalation era for prostate cancer patients undergoing definitive external beam radiotherapy. Eur Urol. 2015;67(6):1009–16.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • David Ambuehl
    • 1
  • Silvan Boxler
    • 1
  • George Thalmann
    • 1
  • Martin Spahn
    • 2
  1. 1.Department of UrologyUniversity Hospital Bern, InselspitalBernSwitzerland
  2. 2.Center for Urology Hirslanden Zürich, Prostate Cancer Center Hirslanden ZürichKlinik Hirslanden Zürich, University of Duisburg-EssenZürichSwitzerland

Section editors and affiliations

  • Thomas Steuber
    • 1
  1. 1.Martini-Klinik am UKE GmbHHamburgGermany

Personalised recommendations