Peter R. Carroll, MD, MPH, presented “Management of Biochemical Recurrence​” during the 31st International Prostate Cancer Update in July 2021 in Snowbird, Utah.

How to cite: Carroll, Peter R. Management of Biochemical Recurrence.” July 2021. Accessed Jun 2024. https://grandroundsinurology.com/prostate-cancer-early-detection-2021/

Management of Biochemical Recurrence – Summary

Peter R. Carroll, MD, MPH, Professor of Prostate Cancer and Urology at the University of California, San Francisco, discusses advancements in knowledge of biochemical recurrence post radical prostatectomy. He begins with an overview of the evolution of radical prostatectomy (RP), highlighting that it has become a treatment option designated for high-risk patients, more multimodal, and more enhanced by biomarker and imaging technology. Dr. Carroll shows data from the CAPTURE trial suggesting that when looking at 18-year cause-specific mortality, RP has a benefit to high risk patients over low risk patients. He reviews data from a Martini-Klinik trial on PSA after RP predicting cancer death that found 75.5% survival in RP patients with detectable PSA vs 96.2% in patients with undetectable PSA. Dr. Carroll also discusses data from a trial he took part in managing which supports the data from Martini-Klinik. He then overviews data from the RAVES, GETUG – AFU 17, and RADICALS RT trials that all compare salvage therapy against adjuvant and found no real difference in outcomes with differences of 3% at most. Dr. Carroll reviews data showing that early adjuvant therapy has a survival benefit for high-risk patients with Gleason scores of 8-10 and UCSF data showing 33% salvage PSA recurrence-free survival post salvage radiation at 10 years. He discusses how empirically based treatment strategies don’t take into account the treatment niches shown by the data he has reviewed and recommends that exact treatment strategies are utilized on a patient by patient basis and that a measured approach to managing biochemical recurrence is utilized.

About The 31st Annual International Prostate Cancer Update:

The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Carroll delivered this educational activity during the 31st iteration of the meeting in July 2021 in Snowbird, Utah.