Salvage radical prostatectomy for radiorecurrent prostate cancer: Indications and results

Darras, Jochen; Joniau, Steven; Poppel, Hendrik Van

doi:10.1016/j.ejso.2006.05.015

Cited by 29 publications

(8 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Surgical complications are certainly a matter of concern; however, studies have suggested that SRP is a safe procedure and shown acceptable functional outcomes [8,23,24]. A recent study with 55 patients has demonstrated a low perioperative complication rate of <10%, with only two cases of rectal injury (3.6%).…”

Section: Discussionmentioning

confidence: 99%

Salvage Radical Prostatectomy for Radiation-recurrent Prostate Cancer: A Multi-institutional Collaboration

et al. 2011

View full text Add to dashboard Cite

Background Oncologic outcomes in men with radiation-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP) are poorly defined. Objective To identify predictors of biochemical recurrence (BCR), metastasis, and death following SRP to help select patients who may benefit from SRP. Design, setting, and participants This is a retrospective, international, multi-institutional cohort analysis. There was a median follow-up of 4.4 yr following SRP performed on 404 men with radiation-recurrent PCa from 1985 to 2009 in tertiary centers. Intervention Open SRP. Measurements BCR after SRP was defined as a serum prostate-specific antigen (PSA) ≥0.1 or ≥0.2 ng/ml (depending on the institution). Secondary end points included progression to metastasis and cancer-specific death. Results and limitations Median age at SRP was 65 yr of age, and median pre-SRP PSA was 4.5 ng/ml. Following SRP, 195 patients experienced BCR, 64 developed metastases, and 40 died from PCa. At 10 yr after SRP, BCR-free survival, metastasis-free survival, and cancer-specific survival (CSS) probabilities were 37% (95% confidence interval [CI], 31–43), 77% (95% CI, 71–82), and 83% (95% CI, 76–88), respectively. On preoperative multivariable analysis, pre-SRP PSA and Gleason score at postradiation prostate biopsy predicted BCR (p = 0.022; global p < 0.001) and metastasis (p = 0.022; global p < 0.001). On postoperative multivariable analysis, pre-SRP PSA and pathologic Gleason score at SRP predicted BCR (p = 0.014; global p < 0.001) and metastasis (p < 0.001; global p < 0.001). Lymph node involvement (LNI) also predicted metastasis (p = 0.017). The main limitations of this study are its retrospective design and the follow-up period. Conclusions In a select group of patients who underwent SRP for radiation-recurrent PCa, freedom from clinical metastasis was observed in >75% of patients 10 yr after surgery. Patients with lower pre-SRP PSA levels and lower postradiation prostate biopsy Gleason score have the highest probability of cure from SRP.

show abstract

Section: Discussionmentioning

confidence: 99%

Salvage Radical Prostatectomy for Radiation-recurrent Prostate Cancer: A Multi-institutional Collaboration

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Journal of Surgical Oncology Ward et al [12] 138 52% (no pads) Na 10 years PFS 77% Bianco et al [13] and Stephenson et al [11] 100 39% (no pads) 84% 5 years PFS 55% Heidenreich et al [14] 21 78% (<2 pads) Na 1 year PFS 92% Van der Poel et al [5] 27 37% (no pads) 93% 5 years PFS 33% Sanderson et al [6] 51 47% (no pads) Decreased QOL/PCI: 13-66 5 years PFS 47% Darras et al [15] 11 45% (no pads) 100% 6.9 years PFS 55% QOL/PCI ¼ Quality of life/UCLA Prostate Cancer Index.…”

Section: Discussionmentioning

confidence: 95%

Sequential treatment for recurrent localized prostate cancer

Poel¹,

Moonen²,

Horenblas³

2008

Journal of Surgical Oncology

View full text Add to dashboard Cite

To compare toxicity and efficacy of both salvage prostatectomy and salvage radiotherapy for prostate cancer a retrospective analysis was conducted. Thirty-two and 41 patients were treated with external beam radiotherapy or prostatectomy for cT1c-T2 prostate cancer later requiring salvage surgery or radiotherapy. Salvage surgery was performed when a local recurrence was biopsy confirmed and life-expectancy was more than 10 years. Salvage external beam radiotherapy was performed when PSA rose over 0.1 ng/ml in the absence of systemic disease. Ten-year PSA-recurrence free survival after primary treatment in the salvage surgery group and salvage radiotherapy groups was 55% and 44% (P > 0.05) respectively whereas prostate cancer specific survival was 93% and 89%, respectively (P > 0.05). Both, biopsy Gleason score prior to primary treatment and PSADT prior to salvage treatment were predictive of PSA-recurrence free survival. Patients after salvage radiotherapy (13%) were less likely to wear pads for urinary incontinence compared to patients after salvage surgery (56%). Erectile dysfunction was more frequent after salvage surgery (81%) compared to salvage radiotherapy (61%). Salvage surgery and salvage prostatectomy after primary cT1-2 prostate cancer provide comparable PSA-recurrence free survival after primary treatment. Genitourinary functions were better preserved in the salvage radiotherapy group compared to the salvage prostatectomy group.

show abstract

“…Los trabajos que analizan el uso de RT adyuvante o de rescate después de PR observan mayores efectos adversos sexuales y rectales, sin empeoramientos no obstante del estado de continencia que se presentaba tras la PR 8 , incluso después de un rescate con RT de alta tasa (70 Gy) 9 . Cuando el tratamiento primario es RT y se opta por una PR de rescate la morbilidad se multiplica, incluso en manos expertas, con tasas de incontinencia superiores al 50% 10 , aumentando además el riesgo de esclerosis cervical y la pérdida completa de potencia sexual en los pacientes que todavía la conservaban 11 . Además, existe un mayor riesgo de lesión rectal durante la PR en el territorio irradiado, que probablemente condenará al paciente a una colostomía definitiva.…”

Section: Resultados Funcionalesunclassified

Revisión crítica del uso de radiación como tratamiento inicial del cáncer de próstata localizado

et al. 2010

View full text Add to dashboard Cite

Salvage radical prostatectomy for radiorecurrent prostate cancer: Indications and results

Cited by 29 publications

References 27 publications

Salvage Radical Prostatectomy for Radiation-recurrent Prostate Cancer: A Multi-institutional Collaboration

Salvage Radical Prostatectomy for Radiation-recurrent Prostate Cancer: A Multi-institutional Collaboration

Sequential treatment for recurrent localized prostate cancer

Revisión crítica del uso de radiación como tratamiento inicial del cáncer de próstata localizado

Contact Info

Product

Resources

About