PSA Kinetics and Bone Marrow Micrometastasis to Define Relapse in Men after Radical Prostatectomy for Prostate Cancer

Biochemical failure (BF) after radical prostatectomy for prostate cancer, occurs in approximately 30% of patients. Although there have been cases described of BF of up to 10-15 years after surgery, it usually occurs within 12 months post surgery, with 95% occurring within the first five years (Pound et al., 1997; Han et al., 2003). Although different guidelines have defined biochemical failure with differing levels of serum PSA, the NCCN guidelines (2014) use a level of 0.2ng/ml while the UK NICE guidelines recomended a cutoff point of 0.4ng/ml as did Amling et al (2001), who reported that only 49% of men with a PSA of 0.2ng/ml progressed within a three year period. Freedland et al (2003) showed that a PSA of >0.2ng/ml is appropriate to define PSA recurrence, reporting that 100% of such patients had a risk of PSA progession within 3 years. Once biochemcial failure has