Salvage Laparoscopic Radical Prostatectomy Following High-intensity Focused Ultrasound for Treatment of Prostate Cancer

Leonardo, Costantino; Franco, Giorgio; Nunzio, Cosimo De; Tubaro, Andrea; Salvitti, Mariarita; Tartaglia, Nicola; Simonelli, Giovanni; Dominicis, C. De

doi:10.1016/j.urology.2012.04.014

Cited by 16 publications

(16 citation statements)

References 14 publications

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“…The rate of PSM in our present series was close to 40%, which is within the expected rate when compared with sRP after RT, but higher than expected when compared with primary RP [17,20]. However, the PSM rate is higher in our present series compared to previous series (15-27%) [5,12] Transfusion rates and hospital stay are both consistent with published series [21,22]. As previous studies have shown, PSMs are associated with a higher rate of recurrence [23,24].…”

Section: Discussionsupporting

confidence: 90%

Salvage radical prostatectomy following focal therapy: functional and oncological outcomes

Herrera-Cáceres

Salgado-Sanmamed

et al. 2020

BJU International

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Objectives To report the oncological and functional outcomes of salvage radical prostatectomy (sRP) after focal therapy (FT). Patients and Methods A retrospective review of all patients who underwent sRP after FT was performed. Clinical and pathological outcomes focussed on surgical complications, oncological, and functional outcomes. Results In all, 34 patients were identified. The median (interquartile range [IQR]) age was 61 (8.25) years. FT modalities included high‐intensity focussed ultrasound (19 patients), laser ablation (13), focal brachytherapy (one) and cryotherapy (one). The median (IQR) time from FT to recurrence was 10.9 (17.6) months. There were no rectal or ureteric injuries. Two (5.9%) patients had iatrogenic cystotomies and four (11.8%) developed bladder neck contractures. The mean (sd) hospital stay was 2.5 (2.1) days. The T‐stage was pT2 in 14 (41.2%) patients, pT3a in 16 (47.1%), and pT3b in four (11.8%). In all, 13 (38%) patients had positive surgical margins (PSMs). Six (17.6%) patients received adjuvant radiotherapy (RT). At a mean follow‐up of 4.3 years, seven (20.6%) patients developed biochemical recurrence (BCR), and of these, six (17.6%) patients required salvage RT. PSMs were associated with worse BCR‐free survival (hazard ratio 6.624, 95% confidence interval 2.243–19.563; P < 0.001). The median (IQR) preoperative International Prostate Symptom Score and International Index of Erectile Function score was 7 (4.5–9.5) and 23.5 (15.75–25) respectively, while in the final follow‐up the median (IQR) values were 7 (3.5–11) and 6 (5–12.25), respectively (P = 0.088 and P < 0.001). At last follow‐up, 31 (91.2%) patients were continent, two (5.9%) had moderate (>1 pad/day) incontinence, and one (2.9%) required an artificial urinary sphincter. Conclusions sRP should be considered as an option for patients who have persistent clinically significant prostate cancer or recurrence after FT. PSMs should be recognised as a risk for recurrent disease after sRP.

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Section: Discussionsupporting

confidence: 90%

Salvage radical prostatectomy following focal therapy: functional and oncological outcomes

Herrera-Cáceres

Salgado-Sanmamed

et al. 2020

BJU International

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“…To our knowledge, there are very few reports about surgery after HIFU treatment; Leonardo et al [14] and Lawrentschuk et al [15] reported the outcome of 13 and 15 patients, respectively, showing the feasibility of radical prostatectomy after HIFU, but at a higher morbidity than for primary surgery. Biochemical control was not assessable due to the short follow-up (Leonardo et al [14] reported a mean follow-up of 14 months and Lawrentschuk et al [15] a median follow-up of 22 months).…”

Section: Discussionmentioning

confidence: 99%

“…Biochemical control was not assessable due to the short follow-up (Leonardo et al [14] reported a mean follow-up of 14 months and Lawrentschuk et al [15] a median follow-up of 22 months).…”

Section: Discussionmentioning

confidence: 99%

Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

et al. 2013

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Introduction: The main objective was to evaluate feasibility, toxicity and biochemical control rates of salvage external beam radiotherapy (EBRT) in recurrent localized prostate cancer after high-intensity focused ultrasound (HIFU) as primary therapy. Patients and Methods: A total of 24 patients who underwent salvage EBRT after 1 or 2 HIFU sessions and with a minimum post-treatment follow-up of 24 months were retrospectively evaluated. Primary endpoints were toxicity and biochemical disease-free survival (bDFS, defined according to the ASTRO Phoenix definition). Results: Median follow-up was 40.3 months. Gastrointestinal toxicity was low. Acute genitourinary (GU) toxicity grade ≤II rate was 45.8%, with only few patients presenting grade III (8.3%) and grade IV (4.2%) toxicity. Late grade ≥III GU toxicity was registered in 16.7% of patients. The 3-year bDFS rate was 77.8%. Patients achieving a nadir prostate-specific antigen (nPSA) of ≤0.35 ng/ml after EBRT had significantly higher bDFS (3-year bDFS: 87.7 vs. 50%, respectively; p = 0.001). Achieving nPSA ≤0.35 ng/ml was the only factor independently associated to long-term bDFS both on univariate (p = 0.01) and multivariate analysis (HR 7.06, p = 0.039). Conclusions: Salvage EBRT after HIFU failure is feasible and allows to obtain satisfactory biochemical control rates, especially in patients attaining a nPSA ≤0.35 ng/ml after EBRT.

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“…Contrary to other series of salvage prostatectomy following focal therapy, surgery after VTP seems feasible 9,13 . Surgeons reported that lateral fibrosis made the dissection of nerve bundles difficult on the VTP treated-side.…”

Section: A N U S C R I P Tmentioning

confidence: 89%

“…Despite studies showing a short-term effectiveness of focal treatments in selected patients and tumours 5,6 , the use of focal therapy needs to be thoroughly studied 7,8 . A major question is to assess the impact of focal therapies on the subsequent therapeutic options in case of failure 9,10 . Therefore, the aim of this study was to assess the feasibility, the safety and the efficacy of salvage RP for recurrent PCa after TOOKAD® VTP.…”

Section: Introductionmentioning

confidence: 99%

Radical Prostatectomy after Vascular Targeted Photodynamic Therapy with Padeliporfin: Feasibility, and Early and Intermediate Results

et al. 2019

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Salvage Laparoscopic Radical Prostatectomy Following High-intensity Focused Ultrasound for Treatment of Prostate Cancer

Cited by 16 publications

References 14 publications

Salvage radical prostatectomy following focal therapy: functional and oncological outcomes

Salvage radical prostatectomy following focal therapy: functional and oncological outcomes

Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

Radical Prostatectomy after Vascular Targeted Photodynamic Therapy with Padeliporfin: Feasibility, and Early and Intermediate Results

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