{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:15:59Z","timestamp":1784157359419,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T00:00:00Z","timestamp":1759017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: We evaluated the long-term treatment outcomes of patients with clinically localized and locally advanced prostate cancer (PC) who underwent high-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT). The primary objective was to identify the optimal timing for discontinuing prostate-specific antigen (PSA) monitoring after HDR-BT. Methods: This analysis included 338 patients with PC who received HDR-BT combined with EBRT between 2006 and 2022 and had a minimum follow-up of 5 years. The patients were stratified based on their PSA levels, and factors associated with recurrence were identified. Results: The median observation period was 8.9 years (range, 5.0\u201319.0 years). The 10-year recurrence-free survival rate was 92.0%, with 26 recurrences. PSA levels at 5 and 7 years were significantly correlated with oncological outcomes after HDR-BT. Multivariate analysis revealed that a PSA level of &gt;0.2 ng\/mL at 5 years was an independent poor prognostic factor for recurrence (hazard ratio, 117.57; 95% confidence interval, 6.22\u20132223.37; p = 0.001). No patient with a PSA level of \u22640.2 ng\/mL at 7 years developed recurrences. Conclusions: Based on our long-term data, we propose that PSA monitoring may be safely discontinued in patients with a PSA level of \u22640.2 ng\/mL 7 years after HDR-BT because the risk of recurrence beyond this point is exceedingly low.<\/jats:p>","DOI":"10.3390\/cancers17193151","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T11:40:52Z","timestamp":1759146052000},"page":"3151","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Seven-Year PSA \u2264 0.2 ng\/mL After High-Dose-Rate Brachytherapy Indicates Eligibility for Discontinuing PSA Surveillance in Prostate Cancer"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2554-7048","authenticated-orcid":false,"given":"Tomoyuki","family":"Makino","sequence":"first","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4573-0667","authenticated-orcid":false,"given":"Takayuki","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0743-4413","authenticated-orcid":false,"given":"Shigeyuki","family":"Takamatsu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2503-8908","authenticated-orcid":false,"given":"Ryunosuke","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2553-0497","authenticated-orcid":false,"given":"Taiki","family":"Kamijima","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3543-1236","authenticated-orcid":false,"given":"Hiroshi","family":"Kano","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3599-2217","authenticated-orcid":false,"given":"Hiroaki","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-8834","authenticated-orcid":false,"given":"Hiroshi","family":"Yaegashi","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2118-9135","authenticated-orcid":false,"given":"Kazuyoshi","family":"Shigehara","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9792-2068","authenticated-orcid":false,"given":"Takahiro","family":"Nohara","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8480-9100","authenticated-orcid":false,"given":"Kouji","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5643-2182","authenticated-orcid":false,"given":"Atsushi","family":"Mizokami","sequence":"additional","affiliation":[{"name":"Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,28]]},"reference":[{"key":"ref_1","unstructured":"Spratt, D., Srinivas, S., Schaeffer, E., Adra, N., Ahmed, B., An, Y., Bitting, R., 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