Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline Part III: Salvage Therapy After Radiotherapy or Focal Therapy, Pelvic Nodal Recurrence and Oligometastasis, and Future Directions.

The summary presented herein covers recommendations on salvage therapy for recurrent prostate cancer intended to facilitate care decisions and aid clinicians in caring for patients who have experienced a recurrence following prior treatment with curative intent. This is Part III of a three-part series focusing on evaluation and management of suspected non-metastatic recurrence after radiotherapy (RT) and focal therapy, evaluation and management of regional recurrence, management for molecular imaging metastatic recurrence, and future directions. Please refer to Part I for discussion of treatment decision-making and Part II for discussion of treatment delivery for non-metastatic biochemical recurrence (BCR) after radical prostatectomy (RP).

The systematic review that informs this Guideline was based on searches in Ovid MEDLINE (1946 to July 21, 2022), Cochrane Central Register of Controlled Trials (through August 2022), and Cochrane Database of Systematic Reviews (through August 2022). Update searches were conducted on July 26, 2023. Searches were supplemented by reviewing electronic database reference lists of relevant articles.

In a collaborative effort between AUA, ASTRO, and SUO, the Salvage Therapy for Prostate Cancer Guideline Panel developed evidence- and consensus-based guideline statements to provide guidance for the care of patients who experience BCR after initial definitive local therapy for clinically localized disease.

Continuous and deliberate efforts for multidisciplinary care in prostate cancer will be required to optimize and improve the oncologic and functional outcomes of patients treated with salvage therapies in the future.

The Journal of urology. 2024 Feb 14 [Epub ahead of print]

Todd M Morgan, Stephen A Boorjian, Mark K Buyyounouski, Brian F Chapin, David Y T Chen, Heather H Cheng, Roger Chou, Heather A Jacene, Sophia C Kamran, Sennett K Kim, Erin Kirkby, Amy N Luckenbaugh, Ben J Nathanson, Yaw A Nyame, Edwin M Posadas, Phuoc T Tran, Ronald C Chen

Urology, University of Michigan., Urology, Mayo Clinic., Radiation Oncology, Stanford University., Urology, University of Texas MD Anderson Cancer Center., Urology, Fox Chase Cancer Center-Temple Health., Radiology, Harvard University., Pacific Northwest Evidence-based Practice Center., Radiation Oncology, Massachusetts General Hospital, Harvard Medical School., American Urological Association., Urology, Vanderbilt University., Division of Hematology and Oncology Medicine, University of Washington., Urologic Oncology, Cedars Sinai., Radiation Oncology, University of Maryland., Radiation Oncology, University of Kansas.