Salvage Therapy for Prostate Cancer: Which is Best? Brachytherapyversus Open and Robotic Prostatectomy

No standard salvage therapy exists. The objective of salvage therapy is oncological control with minimum toxicity. Advances in functional imaging, including multi parametric prostate MRI and abdominopelvic lymphangio- MRI, have paved the way for salvage therapy in localised recurrence. To date there are no randomized clinical trials comparing HDR-BT with radical prostatectomy. Methods: We conduct as retrospective review over 20 years comparing outcomes of salvage brachytherapy compared to open and robotic radical prostatectomy, searching Embase and Medline. Results: Whilst robotic radical prostatectomy is a clear winner, there is also a role for salvage brachytherapy. Conclusions: The role of salvage therapies such as brachytherapy need to be further explored.