Biochemical Relapse After Primary Treatment for Prostate Cancer: Studies on Natural History and Therapeutic Considerations

Authors:
Eli Rosenbaum From the Sidney Kimmel Comprehensive Cancer Center and the James Buchanan Brady Urological Institute, Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, Maryland.

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Alan Partin From the Sidney Kimmel Comprehensive Cancer Center and the James Buchanan Brady Urological Institute, Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, Maryland.

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Mario A. Eisenberger From the Sidney Kimmel Comprehensive Cancer Center and the James Buchanan Brady Urological Institute, Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, Maryland.

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Volume/Issue:
Volume 2: Issue 3
Online Publication Date:
May 2004
DOI:
https://doi.org/10.6004/jnccn.2004.0022
Full access

After local treatment, a substantial proportion of patients with prostate cancer present with rising prostate specific antigen (PSA) serum levels as the only indication of disease activity. Evolving data derived from large databases that were predominantly retrospectively evaluated show that the natural history of these patients is quite variable. Various clinical and pathologic parameters have been shown to predict for the probability of development of distant metastasis, including the surgical Gleason score, time of PSA relapse after primary treatment, and PSA doubling time (PSADT). The PSADT appears to be the most important predictor of development of distant metastasis and prostate cancer-specific mortality. At present, no data support a standard management approach for these patients, and clinical trials pose a major challenge in view of the methodologic complexities involved. Patients and treating physicians should make major efforts to participate in clinical trials in this patient population.

Correspondence: Mario Eisenberger, MD, Johns Hopkins Medical Institutions, 1650 Orleans Street, Blaustein/Bunting Cancer Research Building, Room 1M 51, Baltimore, MD 21231-1000. E-mail: eisenma@jhmi.edu
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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
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Copyright:
Copyright © 2004 by the National Comprehensive Cancer Network 2004
Page Numbers:
8
Article Category:
Research Article
Received:
03 Feb 2004
Accepted:
04 Mar 2004
Print Publication Date:
01 May 2004
Online Publication Date:
May 2004
Keywords:
Prostate cancer; biochemical relapse; prostate-specific antigen (PSA); PSA doubling time (PSADT); salvage therapy; systemic treatment

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