Limits...
Salvage open radical prostatectomy after failed radiation therapy: a single center experience.

Gorin MA, Manoharan M, Shah G, Eldefrawy A, Soloway MS - Cent European J Urol (2011)

Bottom Line: Postoperative bladder neck contracture and urinary incontinence developed in 17% and 39% of men, respectively.Overall and recurrence-free survival at 5-years was 90% and 39%, respectively.On multivariate analysis, extracapsular extension was the only significant predictor of biochemical recurrence (HR 6.9, 95% CI 1.9-25.3 p = 0.003).

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.

ABSTRACT

Introduction: Currently there is no universally accepted approach for the management of radiation-recurrent prostate cancer. The aim of this study was to detail our experience performing salvage radical prostatectomy for patients who failed primary treatment of prostate cancer with radiation therapy.

Material and methods: We retrospectively queried our institutional database of radical prostatectomy cases for patients who underwent salvage surgery for radiation-recurrent prostate cancer. Patients were assessed for the risk of complications and oncologic outcomes following salvage surgery.

Results: Twenty-four patients with a mean age of 65 years (range 51-74) underwent salvage radical prostatectomy. Fourteen of these patients (58%) received androgen deprivation therapy prior to surgery. Intraoperatively, mean blood loss was estimated at 415 mL (range 100-1000) and 19 (79%) patients received autologous blood. No patient required an allogeneic transfusion or experienced a rectal injury. Postoperative bladder neck contracture and urinary incontinence developed in 17% and 39% of men, respectively. Two (29%) of seven patients remained potent after salvage surgery. No patient developed a fistula. Overall and recurrence-free survival at 5-years was 90% and 39%, respectively. On multivariate analysis, extracapsular extension was the only significant predictor of biochemical recurrence (HR 6.9, 95% CI 1.9-25.3 p = 0.003).

Conclusion: In carefully selected patients, salvage radical prostatectomy for radiation-recurrent prostate cancer is a treatment option with acceptable oncologic outcomes and a moderate complication rate.

No MeSH data available.


Related in: MedlinePlus

Biochemical recurrence-free survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3921722&req=5

Figure 0001: Biochemical recurrence-free survival.

Mentions: BCR was detected in 14 patients (58%) at a median interval of 24 months (Fig. 1). Eight of these patients were treated with androgen deprivation. On univariate Cox proportional hazards analysis (Table 2), extracapsular extension was the only significant predictor of BCR (HR 6.9, 95% CI 1.9-25.3 p = 0.003). This result was unchanged on multivariate analysis. During follow-up, six (25%) patients died, two (8%) due to PCa (Fig. 2). One patient died with metastatic PCa at 18 months after SRP with a pathologic Gleason score of 9 and positive lymph nodes. The other died nine years after surgery with Gleason 7 PCa and extraprostatic extension.


Salvage open radical prostatectomy after failed radiation therapy: a single center experience.

Gorin MA, Manoharan M, Shah G, Eldefrawy A, Soloway MS - Cent European J Urol (2011)

Biochemical recurrence-free survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921722&req=5

Figure 0001: Biochemical recurrence-free survival.
Mentions: BCR was detected in 14 patients (58%) at a median interval of 24 months (Fig. 1). Eight of these patients were treated with androgen deprivation. On univariate Cox proportional hazards analysis (Table 2), extracapsular extension was the only significant predictor of BCR (HR 6.9, 95% CI 1.9-25.3 p = 0.003). This result was unchanged on multivariate analysis. During follow-up, six (25%) patients died, two (8%) due to PCa (Fig. 2). One patient died with metastatic PCa at 18 months after SRP with a pathologic Gleason score of 9 and positive lymph nodes. The other died nine years after surgery with Gleason 7 PCa and extraprostatic extension.

Bottom Line: Postoperative bladder neck contracture and urinary incontinence developed in 17% and 39% of men, respectively.Overall and recurrence-free survival at 5-years was 90% and 39%, respectively.On multivariate analysis, extracapsular extension was the only significant predictor of biochemical recurrence (HR 6.9, 95% CI 1.9-25.3 p = 0.003).

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.

ABSTRACT

Introduction: Currently there is no universally accepted approach for the management of radiation-recurrent prostate cancer. The aim of this study was to detail our experience performing salvage radical prostatectomy for patients who failed primary treatment of prostate cancer with radiation therapy.

Material and methods: We retrospectively queried our institutional database of radical prostatectomy cases for patients who underwent salvage surgery for radiation-recurrent prostate cancer. Patients were assessed for the risk of complications and oncologic outcomes following salvage surgery.

Results: Twenty-four patients with a mean age of 65 years (range 51-74) underwent salvage radical prostatectomy. Fourteen of these patients (58%) received androgen deprivation therapy prior to surgery. Intraoperatively, mean blood loss was estimated at 415 mL (range 100-1000) and 19 (79%) patients received autologous blood. No patient required an allogeneic transfusion or experienced a rectal injury. Postoperative bladder neck contracture and urinary incontinence developed in 17% and 39% of men, respectively. Two (29%) of seven patients remained potent after salvage surgery. No patient developed a fistula. Overall and recurrence-free survival at 5-years was 90% and 39%, respectively. On multivariate analysis, extracapsular extension was the only significant predictor of biochemical recurrence (HR 6.9, 95% CI 1.9-25.3 p = 0.003).

Conclusion: In carefully selected patients, salvage radical prostatectomy for radiation-recurrent prostate cancer is a treatment option with acceptable oncologic outcomes and a moderate complication rate.

No MeSH data available.


Related in: MedlinePlus