{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T12:28:17Z","timestamp":1786796897263,"version":"build-2736575974"},"reference-count":34,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thegreenjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Radiotherapy and Oncology"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.radonc.2026.111640","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:58:34Z","timestamp":1781312314000},"page":"111640","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["PSA persistence in the PSMA PET era: reassessing a risk factor after radical prostatectomy"],"prefix":"10.1016","volume":"222","author":[{"given":"Sophia","family":"Scharl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2637-0400","authenticated-orcid":false,"given":"Reinhard","family":"Thamm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantinos","family":"Zamboglou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6229-5471","authenticated-orcid":false,"given":"Iosif","family":"Strouthos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Farolfi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7470-0614","authenticated-orcid":false,"given":"Francesca","family":"Serani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan A.","family":"Koerber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan C.","family":"Peeken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2942-6761","authenticated-orcid":false,"given":"Marco M.E.","family":"Vogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie G.C.","family":"Kroeze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7146-9071","authenticated-orcid":false,"given":"Matthias","family":"Guckenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Krafcsik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Hruby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Emmett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina-Sophie","family":"Schmidt-Hegemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5382-5933","authenticated-orcid":false,"given":"Christian","family":"Trapp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2727-8005","authenticated-orcid":false,"given":"Simon K.B.","family":"Spohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Henkenberens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1042-9006","authenticated-orcid":false,"given":"Benjamin","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6477-6655","authenticated-orcid":false,"given":"Mohamed","family":"Shelan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9493-3834","authenticated-orcid":false,"given":"Daniel M.","family":"Aebersold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Eberhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Debus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Wiegel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.radonc.2026.111640_b0005","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.ijrobp.2014.09.039","article-title":"Prostate-specific antigen persistence after radical prostatectomy as a predictive factor of clinical relapse-free survival and overall survival: 10-year data of the ARO 96-02 trial","volume":"91","author":"Wiegel","year":"2015","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111640_b0010","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.eururo.2015.12.010","article-title":"The role of prostate-specific antigen persistence after radical prostatectomy for the prediction of clinical progression and cancer-specific mortality in node-positive prostate cancer patients","volume":"69","author":"Bianchi","year":"2016","journal-title":"Eur Urol"},{"key":"10.1016\/j.radonc.2026.111640_b0015","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s11701-016-0606-8","article-title":"Predictive factors and oncological outcomes of persistently elevated prostate-specific antigen in patients following robot-assisted radical prostatectomy","volume":"11","author":"Kumar","year":"2017","journal-title":"J Robot Surg"},{"key":"10.1016\/j.radonc.2026.111640_b0020","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/j.eururo.2017.06.001","article-title":"Impact of postoperative radiotherapy in men with persistently elevated prostate-specific antigen after radical prostatectomy for prostate cancer: a long-term survival analysis","volume":"72","author":"Gandaglia","year":"2017","journal-title":"Eur Urol"},{"key":"10.1016\/j.radonc.2026.111640_b0025","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.eururo.2019.01.048","article-title":"Persistent prostate-specific antigen after radical prostatectomy and its impact on oncologic outcomes","volume":"76","author":"Preisser","year":"2019","journal-title":"Eur Urol"},{"key":"10.1016\/j.radonc.2026.111640_b0030","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1111\/bju.14851","article-title":"The impact of prostate-specific antigen persistence after radical prostatectomy on the efficacy of salvage radiotherapy in patients with primary N0 prostate cancer","volume":"124","author":"Bartkowiak","year":"2019","journal-title":"BJU Int"},{"key":"10.1016\/j.radonc.2026.111640_b0035","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.euo.2021.01.001","article-title":"Management of persistently elevated prostate-specific antigen after radical prostatectomy: a systematic review of the literature","volume":"4","author":"Ploussard","year":"2021","journal-title":"Eur Urol Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0040","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2023.109678","article-title":"Salvage radiotherapy is effective in patients with PSMA-PET-negative biochemical recurrence- results of a retrospective study","volume":"184","author":"Scharl","year":"2023","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0045","first-page":"00409","article-title":"Metastasis-free survival and patterns of distant metastatic disease after PSMA-PET-guided salvage radiotherapy in recurrent or persistent prostate cancer after prostatectomy","volume":"S0360\u20133016","author":"Zamboglou","year":"2022","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111640_b0050","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.3390\/cancers13102453","article-title":"The significance of prostate specific antigen persistence in prostate cancer risk groups on long-term oncological outcomes","volume":"13","author":"Milonas","year":"2021","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.radonc.2026.111640_b0055","doi-asserted-by":"crossref","DOI":"10.1016\/j.canrad.2025.104619","article-title":"Long-term outcomes of radiotherapy and impact of nodal disease burden in clinically node-positive prostate cancer","volume":"29","author":"Felefly","year":"2025","journal-title":"Cancer Radiother"},{"key":"10.1016\/j.radonc.2026.111640_b0060","doi-asserted-by":"crossref","first-page":"248","DOI":"10.2967\/jnumed.121.262411","article-title":"The European Association of urology biochemical recurrence risk groups predict findings on PSMA PET in patients with biochemically recurrent prostate cancer after radical prostatectomy","volume":"63","author":"Dong","year":"2022","journal-title":"J Nucl Med"},{"key":"10.1016\/j.radonc.2026.111640_b0065","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s13014-018-0983-4","article-title":"Outcome after PSMA PET\/CT based radiotherapy in patients with biochemical persistence or recurrence after radical prostatectomy","volume":"13","author":"Schmidt-Hegemann","year":"2018","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0070","doi-asserted-by":"crossref","DOI":"10.3390\/cancers17233747","article-title":"Redefining prostate cancer precision: radiogenomics, theragnostics, and AI-driven biomarkers","volume":"17","author":"Dorado","year":"2025","journal-title":"Cancers"},{"key":"10.1016\/j.radonc.2026.111640_b0075","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.eururo.2025.03.003","article-title":"A comprehensive systematic review and meta-analysis of the role of prostate-specific membrane antigen positron emission tomography for prostate cancer diagnosis and primary staging before definitive treatment","volume":"87","author":"Mazzone","year":"2025","journal-title":"Eur Urol"},{"key":"10.1016\/j.radonc.2026.111640_b0080","article-title":"ESTRO ACROP guideline on prostate bed delineation for postoperative radiotherapy in prostate cancer","volume":"41","author":"Dal Pra","year":"2023","journal-title":"Clin Transl Radiat Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0085","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2021.665304","article-title":"Changes of Radiation treatment concept based on 68Ga-PSMA-11-PET\/CT in early PSA-recurrences after radical prostatectomy","volume":"11","author":"Bottke","year":"2021","journal-title":"Front Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0090","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.2967\/jnumed.121.263521","article-title":"Changes in management after 18F-DCFPyL PSMA PET in patients undergoing postprostatectomy radiotherapy, with early biochemical response outcomes","volume":"63","author":"Ng","year":"2022","journal-title":"J Nucl Med"},{"key":"10.1016\/j.radonc.2026.111640_b0095","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s11864-024-01181-9","article-title":"Impact of PSMA PET on prostate cancer management","volume":"25","author":"Weiner","year":"2024","journal-title":"Curr Treat Options Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0100","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1016\/S0140-6736(21)00581-X","article-title":"18F-fluciclovine-PET\/CT imaging versus conventional imaging alone to guide postprostatectomy salvage radiotherapy for prostate cancer (EMPIRE-1): a single centre, open-label, phase 2\/3 randomised controlled trial","volume":"397","author":"Jani","year":"2021","journal-title":"Lancet"},{"key":"10.1016\/j.radonc.2026.111640_b0105","article-title":"Better oncological outcomes after prostate-specific membrane antigen positron emission tomography\u2013guided salvage radiotherapy following prostatectomy","author":"Zamboglou","year":"2024","journal-title":"Eur Urol Focus"},{"key":"10.1016\/j.radonc.2026.111640_b0110","doi-asserted-by":"crossref","first-page":"S35","DOI":"10.1016\/j.ijrobp.2022.07.394","article-title":"Impact of PSMA PET\/CT on prostate cancer salvage radiotherapy management: results from the prospective randomized phase 3 trial [PSMA SRT NCT03582774]","volume":"114","author":"Armstrong","year":"2022","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111640_b0115","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.eururo.2024.01.012","article-title":"Impact of prostate-specific membrane antigen positron emission tomography\/computed tomography on prostate cancer salvage radiotherapy management: results from a prospective multicenter randomized phase 3 trial (PSMA-SRT NCT03582774)","volume":"86","author":"Armstrong","year":"2024","journal-title":"Eur Urol"},{"key":"10.1016\/j.radonc.2026.111640_b0120","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1001\/jamaoncol.2025.3746","article-title":"Prostate-specific membrane antigen PET-guided intensification of salvage radiotherapy after radical prostatectomy: a phase 2 randomized clinical trial","volume":"11","author":"Belliveau","year":"2025","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0125","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/j.euo.2025.05.006","article-title":"Influence of Concomitant androgen deprivation therapy and its duration for salvage radiation after radical prostatectomy: a systematic review and network meta-analysis according to published data","volume":"8","author":"Le","year":"2025","journal-title":"Eur Urol Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0130","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/S1470-2045(25)00197-4","article-title":"Salvage metastasis-directed therapy versus elective nodal radiotherapy for oligorecurrent nodal prostate cancer metastases (PEACE V\u2013STORM): a phase 2, open-label, randomised controlled trial","volume":"26","author":"Ost","year":"2025","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0135","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.eururo.2020.09.046","article-title":"EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer. Part II-2020 update: treatment of relapsing and metastatic prostate cancer","volume":"79","author":"Cornford","year":"2021","journal-title":"Eur Urol"},{"key":"10.1016\/j.radonc.2026.111640_b0140","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1038\/s41598-023-50434-4","article-title":"Impact of radiation doses on clinical relapse of biochemically recurrent prostate cancer after prostatectomy","volume":"14","author":"Takano","year":"2024","journal-title":"Sci Rep"},{"key":"10.1016\/j.radonc.2026.111640_b0145","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejmech.2023.115966","article-title":"A systematic review on the current status of PSMA-targeted imaging and radioligand therapy","volume":"263","author":"Capasso","year":"2024","journal-title":"Eur J Med Chem"},{"key":"10.1016\/j.radonc.2026.111640_b0150","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.ijrobp.2009.02.006","article-title":"Development of RTOG consensus guidelines for the definition of the clinical target volume for postoperative conformal radiation therapy for prostate cancer","volume":"76","author":"Michalski","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111640_b0155","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.ijrobp.2020.08.034","article-title":"NRG oncology updated international consensus atlas on pelvic lymph node volumes for intact and postoperative prostate cancer","volume":"109","author":"Hall","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.radonc.2026.111640_b0160","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.radonc.2008.05.006","article-title":"Post-prostatectomy radiation therapy: consensus guidelines of the Australian and New Zealand Radiation Oncology Genito-Urinary Group","volume":"88","author":"Sidhom","year":"2008","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0165","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.radonc.2018.06.027","article-title":"Radiotherapy for recurrent prostate cancer: 2018 Recommendations of the Australian and New Zealand Radiation Oncology Genito-Urinary group","volume":"129","author":"Lieng","year":"2018","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.radonc.2026.111640_b0170","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.radonc.2007.07.017","article-title":"Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group","volume":"84","author":"Poortmans","year":"2007","journal-title":"Radiother Oncol"}],"container-title":["Radiotherapy and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167814026004792?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0167814026004792?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T12:17:10Z","timestamp":1786796230000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0167814026004792"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":34,"alternative-id":["S0167814026004792"],"URL":"https:\/\/doi.org\/10.1016\/j.radonc.2026.111640","relation":{},"ISSN":["0167-8140"],"issn-type":[{"value":"0167-8140","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"PSA persistence in the PSMA PET era: reassessing a risk factor after radical prostatectomy","name":"articletitle","label":"Article Title"},{"value":"Radiotherapy and Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.radonc.2026.111640","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"111640"}}