Local therapy for prostate-specific antigen recurrence after definitive treatment

Disease recurrence after local therapy for prostate cancer is increasingly common, most often with detectable or rising prostate-specific antigen (PSA ) the earliest sign. Analysis of clinical and pathological factors can help determine which patients are at risk for treatment failure, while PSA char acteristics and imaging studies can localize site of recurrent disease and identify men who may benefit from salvage therapy. Local treatment options include radiation therapy (external beam and brachytherapy) and cryoablatio n for patients who have undergone prostatectomy, and surgery, brachytherapy , and cryoablation for patients who have received radiotherapy. Novel treat ment modalities are under investigation and may improve success of local sa lvage therapy while minimizing morbidity.