“…12,19 -21 In most studies on localized prostate cancer today, biochemical failure represents the outcome parameter either alone or often in combination with clinical progression. 28,29 However, as shown by Kupelian et al, rising PSA after curatively intended local treatment in general predicts the development of clinical progression, often after long intervals. 30 Pound et al reported that PSA progression preceded the diagnosis of distant metastases by a median time of 8 years after radical prostatectomy.…”