A Comprehensive Review of the Current State of Robot-assisted Laparoscopic Salvage Prostatectomy

Thakker, Parth U.; Sandberg, Maxwell; Hemal, Ashok K.; Rodriguez, Alejandro R.

doi:10.1590/s1677-5538.ibju.2024.0126

Int. braz j urol.

2024

DOI: 10.1590/s1677-5538.ibju.2024.0126

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A Comprehensive Review of the Current State of Robot-assisted Laparoscopic Salvage Prostatectomy

Parth U. Thakker,

Maxwell Sandberg,

Ashok K. Hemal

et al.

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Cited by 3 publications

References 71 publications

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International Brazilian Journal of Urology highlights experimental studies in Infertility in this number

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2024

Int. braz j urol.

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International Brazilian Journal of Urology highlights experimental studies in Infertility in this number

Favorito

2024

Int. braz j urol.

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Oncologic and Functional Outcomes of Salvage Robot-Assisted Radical Prostatectomy: Report of the First 10 Cases

Oshina,

Yamada,

Fujimura

et al. 2024

Current Oncology

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Background: Salvage robot-assisted radical prostatectomy (sRARP) after PSA failure in patients who underwent initial radiotherapy or focal therapy has rarely been reported in Japan. We aimed to report the oncologic and functional outcomes of the first 10 cases of sRARP. Methods: Ten patients underwent sRARP after failing to respond to initial radiotherapy or focal therapy. Initial definitive treatment included volumetric modulated arc therapy, intensity-modulated radio therapy, stereotactic body radiotherapy, heavy-ion radiotherapy, low-dose-rate brachytherapy, and high-intensity focused ultrasound. We retrospectively investigated 10 cases on oncologic and functional outcomes of sRARP. Results: The median PSA level at sRARP, amount of blood loss, and console time were 2.17 ng/mL, 100 mL, and 136 min, respectively. Positive surgical margins were found in half of the cases. Median follow-up was 1.1 years. There were no 30-day major complications. No patients had erections after sRARP. Urinary continence and biochemical recurrence (BCR) rate were 40% and 30% at 1 year after sRARP, respectively. Conclusions: Salvage RARP may be a feasible option after PSA failure in patients who underwent radiotherapy or focal therapy as initial treatment, showing acceptable BCR rate.

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High-Intensity Focus Ultrasound Ablation in Prostate Cancer: A Systematic Review

Yang,

Barbulescu,

Marian

et al. 2024

JPM

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Background/Objectives: Prostate cancer (PCa) outcomes vary significantly across risk groups. In early-stage localized PCa, the functional outcomes following radical prostatectomy (RP) can be severe, prompting increased interest in focal therapy, particularly High-Intensity Focused Ultrasound (HIFU). This study is to summarize the current clinical trials of HIFU on PCa. Methods: We reviewed clinical trials from major databases, including PubMed, MEDLINE, Scopus, and EMBASE, to summarize the current research on HIFU in PCa treatment. Results: The literature highlights that HIFU may offer superior functional outcomes, particularly in continence recovery, compared to RP and radiation therapy. However, the oncological efficacy of HIFU remains inadequately supported by high-quality studies. Focal and hemigland ablations carry a risk of residual significant cancer, necessitating comprehensive patient counseling before treatment. For post-HIFU monitoring, we recommend 3T magnetic resonance imaging (MRI) with biopsy at 6 to 12 months to reassess the cancer status. Biochemical recurrence should be defined using the Phoenix criteria, and PSMA PET/CT can be considered for identifying recurrence in biopsy-negative patients. Conclusions: Whole-gland ablation is recommended as the general approach, as it provides a lower PSA nadir and avoids the higher positive biopsy rates observed after focal and hemigland ablation in both treated and untreated lobes. Future study designs should address heterogeneity, including variations in recurrence definitions and surveillance strategies, to provide more robust evidence for HIFU’s oncological outcomes.

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A Comprehensive Review of the Current State of Robot-assisted Laparoscopic Salvage Prostatectomy

Cited by 3 publications

References 71 publications

International Brazilian Journal of Urology highlights experimental studies in Infertility in this number

International Brazilian Journal of Urology highlights experimental studies in Infertility in this number

Oncologic and Functional Outcomes of Salvage Robot-Assisted Radical Prostatectomy: Report of the First 10 Cases

High-Intensity Focus Ultrasound Ablation in Prostate Cancer: A Systematic Review

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