How shoud PSA repalse (rising PSA) be managed after radical prostatectomy? How should treatment algorithms be shaped?

  • İlker Çelen
  • Murat Lekili

Bull Urooncol 2013;12(2):127-131


In this review, current approaches for rising PSA after radical prostatectomy which is one of curative treatments of prostate cancer are discussed.


2 consecutive detections of PSA >0.2 ng / mL in measurements after radical prostatectomy is defined as “biochemical recurrence” and requires secondary treatments. The assesment of prognostic factors including absolute PSA level, time to recurrence, PSA kinetics, multivariable nomograms, imaging and biopsy of the prostatic bed may help stratify the patients into localized or systemic recurrence. Radiotherapy to the prostatic bed, complete / intermittent androgen deprivation, combination of antiandrogens with 5-alfa-reductase inhibitors and the early chemohormonal treatment are the treatment options for biochemical recurrence after radical prostatectomy.


The role of PSA in follow up of patients after radical prostatectomy is important. None of the salvage modalities were shown to have significant positive effects on overall survival, yet. Local or systemic recurrence is important for choosing of the treatment modalities.

Keywords: Prostate cancer, biochemical recurrence, radical prostatectomy