Christian P. Pavlovich, MD, presents “Biochemical Recurrence after Radical Prostatectomy.”
How to cite: Pavlovich, CP. “Biochemical Recurrence after Radical Prostatectomy.” September 9, 2025. Accessed Apr 2026. https://grandroundsinurology.com/biochemical-recurrence-after-radical-prostatectomy/
Biochemical Recurrence after Radical Prostatectomy – Summary
Christian P. Pavlovich, MD, Johns Hopkins School of Medicine, Baltimore, Maryland, discusses biochemical recurrence (BCR) in prostate cancer. In this 14-minute presentation, Dr. Pavlovich emphasizes risk stratification and treatment approaches. He underscores the evolving strategies for managing BCR, emphasizing tailored approaches to improve outcomes.
Dr. Pavlovich highlights that BCR varies widely in prognosis, with factors like PSA doubling time, Gleason score, and surgical margins influencing outcomes. He reviews historical data from Johns Hopkins showing that 15% of patients developed BCR, with one-third progressing to metastases after a median of eight years, underscoring the importance of individualized management.
Dr. Pavlovich shares recent data demonstrating that early salvage radiation improves survival in high-risk patients but may be unnecessary for low-risk cases, where observation is often appropriate. Imaging with PSMA PET is recommended for some patients, enhancing the detection of metastatic sites guiding tailored therapy, and improving treatment planning. Patients with negative imaging or low-risk features may safely undergo observation, while high-risk cases typically require radiation with or without hormonal therapy.
