Salvage Radical Prostatectomy for Recurrent Prostate Cancer Following First-line Nonsurgical Treatment: Validation of the European Association of Urology Criteria in a Large, Multicenter, Contemporary Cohort

Calleris, Giorgio; Marra, Giancarlo; Benfant, Nicole; Rajwa, Paweł; Ahmed, Mohamed E.; Abreu, Andre; Cacciamani, Giovanni; Ghoreifi, Alireza; Ribeiro, Luis Henrique Leandro; Westhofen, Thilo; Tourinho-Barbosa, Rafael; Raskin, Yannic; Veerman, Hans; Albisinni, Simone; Smith, Joseph A.; Rouprêt, Morgan; Oderda, Marco; Massari, Emilia; Persad, Raj; Poel, Henk van der; Joniau, Steven; Sánchez-Salas, Rafael; Kretschmer, Alexander; Cathcart, Paul; Gill, Inderbir S.; Karnes, R. Jeffrey; Tilki, Derya; Shariat, Shahrokh F.; Touijer, Karim

doi:10.1016/j.euf.2023.01.006

Cited by 8 publications

(9 citation statements)

References 9 publications

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“…Our univariable analyses indicated that men with Gleason 8–10 PC, pT3 disease, or positive surgical margins are more likely to experience rising PSA or metastases. It has been shown that Gleason score and PSA are significant prognostic factors associated with MFS, progression-free survival, or cancer-specific survival following sRP [16] , [17] , [18] . A systematic review by Chade et al [6] suggested that preoperative PSA is one of the strongest predictors of recurrence for these men.…”

Section: Discussionmentioning

confidence: 99%

Long-term Outcomes and Patient Satisfaction Following Salvage Robot-assisted Radical Prostatectomy: A Modern Perspective

Lama,

Thomas,

Ferenczi

et al. 2024

European Urology Open Science

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Section: Discussionmentioning

confidence: 99%

Long-term Outcomes and Patient Satisfaction Following Salvage Robot-assisted Radical Prostatectomy: A Modern Perspective

Lama,

Thomas,

Ferenczi

et al. 2024

European Urology Open Science

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“…Recent studies described the importance of selection criteria for S-RARP to optimize operative outcomes ( 41 ). According to the European Association of Urology (EAU), candidates for S-RARP should have low comorbidity, life expectancy of at least 10 years, PSA lower than 10, International Society of Urological Pathology (ISUP) grade group ≤ 2/3, no lymph node involvement on preoperative imaging exam, and clinical stage T1 or T2.…”

Section: Discussionmentioning

confidence: 99%

“…Calleris and colleagues described significant differences and benefits for patients selected according to these variables. Unfortunately, being a recent study and guideline by EAU, most articles included in our review were published before 2022 and violated at least one criterion for selecting candidates for S-RARP ( 41 ). Therefore, we believe that outcomes of Robotic-assisted Salvage Prostatectomy should improve in the following years when selecting patients according to these guidelines.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Salvage Robotic-assisted Radical Prostatectomy in the last decade: systematic review and perspectives of referral centers.

Moschovas,

Bravi,

Dell'Oglio

et al. 2023

Int. braz j urol.

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Purpose: Salvage robotic-assisted radical prostatectomy (S-RARP) has gained prominence in recent years for treating patients with cancer recurrence following non-surgical treatments of Prostate Cancer. We conducted a systematic literature review to evaluate the role and outcomes of S-RARP over the past decade. Material and Methods: A systematic review was conducted, encompassing articles published between January 1st, 2013, and June 1st, 2023, on S-RARP outcomes. Articles were screened according to PRISMA guidelines, resulting in 33 selected studies. Data were extracted, including patient demographics, operative times, complications, functional outcomes, and oncological outcomes. Results: Among 1,630 patients from 33 studies, radiotherapy was the most common primary treatment (42%). Operative times ranged from 110 to 303 minutes, with estimated blood loss between 50 to 745 mL. Intraoperative complications occurred in 0 to 9% of cases, while postoperative complications ranged from 0 to 90% (Clavien 1-5). Continence rates varied (from 0 to 100%), and potency rates ranged from 0 to 66.7%. Positive surgical margins were reported up to 65.6%, and biochemical recurrence ranged from 0 to 57%. Conclusion: Salvage robotic-assisted radical prostatectomy in patients with cancer recurrence after previous prostate cancer treatment is safe and feasible. The literature is based on retrospective studies with inherent limitations describing low rates of intraoperative complications and small blood loss. However, potency and continence rates are largely reduced compared to the primary RARP series, despite the type of the primary treatment. Better-designed studies to assess the long-term outcomes and individually specify each primary therapy impact on the salvage treatment are still needed. Future articles should be more specifi c and provide more details regarding the previous therapies and S-RARP surgical techniques.

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“…Most recently, Calleris et al looked to validate the European Association of Urology (EAU) guidelines that recommend restricting salvage radical prostatectomy for radio-recurrent prostate cancer to a favorable-prognosis group: those with organ-confined prostate cancer ≤ stage T2b, pre-RP Gleason score ≤ 7, and pre-SP PSA levels <10 ng/mL [39]. Of the 1030 men in their study, 221 fully met EAU criteria, and the EAU-compliant group experienced more favorable pathological outcomes; the authors reported improved 5-year MFS (90% vs. 76%, p < 0.001), 5-year BFS (55% vs. 38%, p < 0.001), and 5-year OS (89% vs. 84%, p = 0.01) [40]. Overall, the results from these recent series highlight that salvage radical prostatectomy after radiotherapy can achieve excellent tumor control via careful patient selection based on preoperative serum PSA, Gleason scores, and clinical stage.…”

Section: Oncologic Outcomesmentioning

confidence: 92%

The Role of Salvage Radical Prostatectomy in Patients with Radiation-Resistant Prostate Cancer

Drobner

Kaldany

Shah

et al. 2023

Cancers

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There are multiple treatment strategies for patients with localized prostate adenocarcinoma. In intermediate- and high-risk patients, external beam radiation therapy demonstrates effective long-term cancer control rates comparable to radical prostatectomy. In patients who opt for initial radiotherapy but have a local recurrence of their cancer, there is no unanimity on the optimal salvage approach. The lack of randomized trials comparing surgery to other local salvage therapy or observation makes it difficult to ascertain the ideal management. A narrative review of existing prospective and retrospective data related to salvage radical prostatectomy after radiation therapy was undertaken. Based on retrospective and prospective data, post-radiation salvage radical prostatectomy confers oncologic benefits, with overall survival ranging from 84 to 95% at 5 years and from 52 to 77% at 10 years. Functional morbidity after salvage prostatectomy remains high, with rates of post-surgical incontinence and erectile dysfunction ranging from 21 to 93% and 28 to 100%, respectively. Factors associated with poor outcomes after post-radiation salvage prostatectomy include preoperative PSA, the Gleason score, post-prostatectomy staging, and nodal involvement. Salvage radical prostatectomy represents an effective treatment option for patients with biochemical recurrence after radiotherapy, although careful patient selection is important to optimize oncologic and functional outcomes.

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Salvage Radical Prostatectomy for Recurrent Prostate Cancer Following First-line Nonsurgical Treatment: Validation of the European Association of Urology Criteria in a Large, Multicenter, Contemporary Cohort

Cited by 8 publications

References 9 publications

Long-term Outcomes and Patient Satisfaction Following Salvage Robot-assisted Radical Prostatectomy: A Modern Perspective

Long-term Outcomes and Patient Satisfaction Following Salvage Robot-assisted Radical Prostatectomy: A Modern Perspective

Outcomes of Salvage Robotic-assisted Radical Prostatectomy in the last decade: systematic review and perspectives of referral centers.

The Role of Salvage Radical Prostatectomy in Patients with Radiation-Resistant Prostate Cancer

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