Radical prostatectomy for clinical T4 prostate cancer

Abstract

Paravalvular leakage following the atrioventricular valve replacement, though mostly harmless with insignificant morbidity, can result in heart failure and significant hemolysis that requires treatment. Reoperation is still the treatment of choice, but there is a high risk of recurrence, especially in patients with a history of endocarditis and/or those who have already undergone reoperation for paravalvular leakage. Recently, percutaneous closure of perivalvular leaks with occluders or coils have become an alternative to surgery. However, up to now, the collective of patients who benefit from this approach still has to be defined. Here, we present a case of a highly symptomatic 64‐year‐old male with severe hemolysis caused by paravalvular leakages after reoperation of a mechanical mitral valve replacement due to recurrent endocarditis. © 2009 Wiley‐Liss, Inc.

Cystoprostatectomy as a Treatment of Prostate Cancer Involving the Bladder Neck

“…Recently, Johnstone et al [3] reported that radical prostatectomy with or without hormone therapy appeared to have a survival benefit, especially in cT4 PCa patients with positive regional lymph node compared to those with negative lymph node status. Messing et al [11] reported that immediate hormone therapy after radical prostatectomy and pelvic lymphadenectomy improved 5-year cause-specific survival by about 15% in patients with node-positive PCa, although the study targeted patients with cT2 disease.…”

“…They demonstrated that cystoprostatectomy for primary cT4 tumor provided effective and durable palliation of lower urinary tract symptoms (LUTS). Recent data from the Surveillance Epidemiology and End Results (SEER) revealed that patients who underwent radical prostatectomy for cT4 PCa had increased survival compared with patients who received radiation therapy alone or hormone therapy alone and had a survival comparable to that of patients who received combined therapy of radiation and hormone therapy [3] . Furthermore, the study indicated the survival of radical prostatectomy over combined radiation therapy with hormonal therapy for cT4 PCa with lymph node metastases [3] .…”

“…Recent data from the Surveillance Epidemiology and End Results (SEER) revealed that patients who underwent radical prostatectomy for cT4 PCa had increased survival compared with patients who received radiation therapy alone or hormone therapy alone and had a survival comparable to that of patients who received combined therapy of radiation and hormone therapy [3] . Furthermore, the study indicated the survival of radical prostatectomy over combined radiation therapy with hormonal therapy for cT4 PCa with lymph node metastases [3] . Among cT4, compared to patients with PCa involving the rectum or pelvic floor muscles, those with bladder neck invasion may be better candidates for cystoprostatectomy to achieve local cancer control and improvement of QOL.…”

Radical retropubic prostatectomy for prostate cancer with microscopic bladder neck involvement: survival and prognostic implications

“…To the best of our knowledge, there is only one study based on SEER data on RRP in cT4 prostate cancer [12]. Survival rates at 1, 3 and Months after radical prostatectomy Overall survival estimate 5 years were lowest among patients who received no treatment and highest among those who had RRP.…”

“…There are few data published on radical retropubic prostatectomy (RRP) in nonmetastatic prostate carcinoma, which histologically shows neoplastic cells among smooth muscle bundles of the bladder neck [6][7][8][9][10][11]. Indeed, only one publication, based on data from the register of Surveillance Epidemiology and End Results (SEER), has broached the feasibility of radical surgery in clinical T4 prostate cancer [12].…”