Post-Surgical Strategies for Prostate Cancer: Clinicopathologic and Genomics Criteria

Abstract

Radical prostatectomy is widely used as the primary modality of treatment for clinically localised prostate cancer. A considerable proportion of men will have adverse histopathologic features and could benefit from adjunctive treatments: mainly adjuvant or salvage radiation. This review focusses on the still unanswered questions: How to manage the patient after radical prostatectomy? Which patients need further treatment and which ones will not progress if not treated? How to refine patients selection for further treatments? What is the role for clinical nomograms and biomarkers and which ones are validated? When is it wise to propose adjuvant radiation therapy (RT) instead of observation with or without salvage RT? What is the optimal timing for the use of salvage RT and how to choose patients for each approach? This article discusses the evidence available in the current literature, providing a critical analysis of the controversies of each strategy.

Keywords

• postoperative
• biomarkers
• adjuvant therapy
• salvage therapy