Salvage radical prostatectomy after external beam radiation therapy: A systematic review of current approaches

Deliu Victor Matei, Matteo Ferro, Barbara Alicja Jereczek-Fossa, Giuseppe Renne, Nicolae Crisan, Danilo Bottero, Claudia Mazzarella, Daniela Terracciano, Riccardo Autorino, Ottavio De Cobelli

Research output: Contribution to journalArticlepeer-review


Background: Radical external beam radiotherapy (EBRT) is a standard treatment for prostate cancer patients. Despite this, the rate of intraprostatic relapses after primary EBRT is still not negligible. There is no consensus on the most appropriate management of these patients after EBRT failure. For these patients, local salvage therapy such as radical prostatectomy, cryotherapy, and brachytherapy may be indicated. Objective: The objectives of this review were to analyze the eligibility criteria for careful selection of appropriate patients and to evaluate the oncological results and complications for each method. Methods: A review of the literature was performed to identify studies of local salvage therapy for patients who had failed primary EBRT for localized prostate cancer. Results: Most studies demonstrated that local salvage therapy after EBRT may provide long-term local control in appropriately selected patients, although toxicity is often significant. Conclusions: Our results suggest that for localized prostate cancer recurrence after EBRT, the selection of a local treatment modality should be made on a patient-by-patient basis. An improvement in selection criteria and an integrated definition of biochemical failure for all salvage methods are required to determine which provides the best oncological outcome and least comorbidity.

Original languageEnglish
Pages (from-to)373-382
Number of pages10
JournalUrologia Internationalis
Issue number4
Publication statusPublished - Jun 9 2015


  • External beam radiation therapy
  • Oncologic outcome
  • Prostate cancer recurrence
  • Radiation therapy
  • Salvage prostatectomy

ASJC Scopus subject areas

  • Urology


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