Post-Surgical Strategies for Prostate Cancer: Clinicopathologic and Genomics Criteria

Alessandro Morlacco,1 Matteo Soligo,1 Michele Colicchia,2 Avinash Nehra,2 *R. Jeffrey Karnes3

1. Padua University Hospital, Padua, Italy
2. Mayo Clinic, Rochester, Minnesota, USA
3. Urology Department, Mayo Clinic, Rochester, Minnesota, USA
*Correspondence to

Disclosure: R. Jeffrey Karnes has received research funding from GenomeDx and is employed by the Mayo Clinic, which has a financial interest in Decipher/GenomeDx.
Received: 10.04.17 Accepted: 14.09.17
Citation: EMJ Oncol. 2017;5[1]:70-77.


Radical prostatectomy is widely used as the primary modality of treatment for clinically localised prostate cancer. A considerable proportion of men will have adverse histopathologic features and could benefit from adjunctive treatments: mainly adjuvant or salvage radiation.

This review focusses on the still unanswered questions:

  • How to manage the patient after radical prostatectomy? Which patients need further treatment and which ones will not progress if not treated?
  • How to refine patients selection for further treatments? What is the role for clinical nomograms and biomarkers and which ones are validated?
  • When is it wise to propose adjuvant radiation therapy (RT) instead of observation with or without salvage RT?
  • What is the optimal timing for the use of salvage RT and how to choose patients for each approach?

This article discusses the evidence available in the current literature, providing a critical analysis of the
controversies of each strategy.

This article is made available under the terms of theĀ Creative Commons Attribution-Non Commercial 4.0 License.

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