ORLANDO—A planned follow-up of at least 15 years after prostate cancer (PCa) treatment in disease-free men is a reasonable approach to monitor for late recurrence, researchers reported at the American Urological Association 2014 meeting in Orlando.

“Defined as recurrence more than 10 years after treatment, late recurrence of PCa is not a rare event,” the researchers, led by Frank Critz, MD, of Radiotherapy Clinics of Georgia in Decatur, wrote in a study abstract. “A study of this issue is key to answering this pertinent question: how long should disease-free men be followed after treatment of PCa?”

The study included 2,808 PCa patients treated with radiotherapy from 1984–2002. All men were disease free by the surgical definition of recurrence at 10-year follow-up. Forty-eight men had late recurrence. The median time to late recurrence was 12 years and the median follow-up from the time of recurrence was 3 years.

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Four patients who had a PSA of less than 0.2 ng/mL at 15-year follow-up had recurred from 15–20 years, with one who died of metastatic PCa after 25 years.

The late recurrence rate at 10, 15 and 20 years was 0%, 3%, and 5%, respectively, with no recurrence after 20 years.

Based upon relatively short follow-up, most late recurrent cases have a subsequent indolent course, “although at least 1 in 10 will have an aggressive, even lethal outcome,” the authors concluded.