Is it worth to perform salvage radical prostatectomy for radio-recurrent prostate cancer? A literature review

Calleris, Giorgio; Marra, Giancarlo; Dalmasso, Ettore; Falcone, Marco; Karnes, R. Jeffrey; Morlacco, Alessandro; Oderda, Marco; Sánchez-Salas, Rafael; Soria, Francesco

doi:10.1007/s00345-019-02749-z

Cited by 24 publications

(34 citation statements)

References 48 publications

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“…The gross harvest of the prostatic and surrounding tissues demonstrated no overt signs of injury, fibrosis, or adhesions between the prostate and surrounding organs, with the preservation of tissue planes. These findings are in direct contradiction to those of the surgical prostatectomy bed after RT, where severe fibrosis, scarring, and adhesions are routinely noted, often leading to downstream complications (33). Similar to 90 Y RE in the liver, this may lead to the possibility of downstaging prostate cancer patients for resection, and merits further study.…”

Section: Discussionmentioning

confidence: 85%

Yttrium-90 Radioembolization to the Prostate Gland: Proof of Concept in a Canine Model and Clinical Translation

Mouli

Raiter

Harris

et al. 2021

Journal of Vascular and Interventional Radiology

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Section: Discussionmentioning

confidence: 85%

Yttrium-90 Radioembolization to the Prostate Gland: Proof of Concept in a Canine Model and Clinical Translation

Mouli

Raiter

Harris

et al. 2021

Journal of Vascular and Interventional Radiology

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“…5,7 These outcomes are better than after S-RALP following external beam radiation therapy failure (15%-76.9%), where more energy is applied. 21 Energy ablation to prostatic parenchyma leads to conversion into fibrotic tissue, which involves the periprostatic tissue depending on the treated area during FT. 22 Therefore especially margin status and T-stage need careful consideration. In the present study the rates of positive surgical margins after S-RALP were remarkably low.…”

Section: Discussionmentioning

confidence: 99%

Salvage Robotic-assisted Laparoscopic Radical Prostatectomy Following Focal High-Intensity Focused Ultrasound for ISUP 2/3 Cancer

Spitznagel

Hardenberg

Schmid

et al. 2021

Urology

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To report feasibility and outcome of salvage robotic-assisted laparoscopic radical prostatectomy (S-RALP) after focal therapy using high-intensity focused ultrasound (HIFU) treatment compared to primary robotic-assisted laparoscopic radical prostatectomy (pRALP). METHODSIn this bicentric trial patients undergoing S-RALP for detection of WHO2016/ISUP Grade Group 2 or 3 prostate cancer were previously treated in prospective focal HIFU trials. Perioperative data, complications, oncological and functional outcome were analysed. Patients who underwent pRALP were matched in a ratio 2 (pRALP) :1 (S-RALP) according to preoperatively functional, oncological and clinical parameters. RESULTSA total of 39 patients were included in the study (13S-RALP, 26pRALP). Median operative time in the S-RALP group was 260minutes (pRALP: 257minutes), blood loss was 230ml (pRALP: 300ml). Complications occurred in 46.2% (6/13) of S-RALP patients (pRALP: 26.9%), including four Clavien-Dindo III complications (pRALP: 2/26). In S-RALP adverse histological outcome (≥pT3a, pN+ or R1) was detected in 23.1% (3/13) (pRALP: 26.9%). There was one patient with PSA-persistence (pRALP: 2/26). Regarding functional outcomes there was no difference between the two groups observed (incontinence P=.71, erectile function P=.21). CONCLUSION S-RALP should be offered to patients with an early relapse after focal HIFU. The early oncological outcome is satisfactory and functional outcome one year postoperatively is similar to pRALP. However, S-RALP is associated with a higher rate of Clavien-Dindo III complications (mainly, placement of a drainage), of which patients should be informed beforehand. UROLOGY 00: 1 −7, 2021.

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“…Numerous perioperative, oncologic, and functional outcomes of larger sRARP series after RT modalities have been published. 4 ,5,8,9,19, 20 When compared to primary RP, an increased risk of complications, such as short-term post-operative events, anastomotic stricture, urinary retention, urinary fistula, rectal injury, abscess, fibrosis, poor wound healing, ED, and urinary incontinence (UI), is related with salvage RP. 21 - 23 …”

Section: Discussionmentioning

confidence: 99%

Early Experience with Salvage Robotic-Assisted Radical Prostatectomy in Proton Beam Radiotherapy Failures

Bozkurt

Atar²,

Pisters

2021

Balkan Med J

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Aims: To assess the perioperative and short-term functional and oncologic outcomes of the salvage robot-assisted radical prostatectomy (sRARP), after recurrence following primary proton beam therapy for clinically localized prostate cancer. Methods: Ten patients undergoing sRARP after failure of the prior definitive proton beam therapy for localized prostate cancer were included. BCR is defined as a prostate-specific antigen (PSA) value of 2.0 ng/mL greater than the absolute nadir. All of the individuals had a diagnosis of prostate cancer via biopsy after proton beam therapy, with negative findings on magnetic resonance imaging/computer tomography of the pelvis and abdomen, and a bone scan. The sRARP procedure with pelvic lymph node dissection was performed by a single surgeon in all patients. Results: The median age of the cohort at sRARP was 66.8 years, and the mean BMI was 29.2 kg/m 2 . The mean duration from proton beam therapy to sRARP was 58.4 months; the mean preoperative PSA level was 5.5 ng/mL, the mean operative time was 230 minutes, and the approximate blood loss was 745 mL. Anastomotic leakage occurred in half of the individuals, and bladder neck contracture developed in 6 patients. For 8 patients, the continence results within 6 months follow-up were available. Overall, 24 complications occurred in 9 patients. At follow-up in the 32nd month, the overall survival rate was 80%, and the BCR-free survival rate was 90%. Conclusion: sRARP after proton beam therapy is an applicable procedure, but has a high risk of serious complications.

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Is it worth to perform salvage radical prostatectomy for radio-recurrent prostate cancer? A literature review

Cited by 24 publications

References 48 publications

Yttrium-90 Radioembolization to the Prostate Gland: Proof of Concept in a Canine Model and Clinical Translation

Yttrium-90 Radioembolization to the Prostate Gland: Proof of Concept in a Canine Model and Clinical Translation

Salvage Robotic-assisted Laparoscopic Radical Prostatectomy Following Focal High-Intensity Focused Ultrasound for ISUP 2/3 Cancer

Early Experience with Salvage Robotic-Assisted Radical Prostatectomy in Proton Beam Radiotherapy Failures

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