Salvage robotic-assisted radical prostatectomy: oncologic and functional outcomes from two high-volume institutions

Ogaya-Piniés, Gabriel; Linares-Espinós, Estefanía; Hernández-Cardona, Eduardo; Jenson, Cathy; Cathelineau, Xavier; Sánchez-Salas, Rafael; Patel, Vipul

doi:10.1007/s00345-018-2406-4

Cited by 34 publications

(34 citation statements)

References 25 publications

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“…[2][3][4][5][6][7][8][9][10] Radical prostatectomy has moderate efficacy for these patients, albeit with significantly greater complication rates versus radical prostatectomy for previously untreated cases. [2][3][4][5][8][9][10] One large Medicare-based Surveillance, Epidemiology, and End Results Program (SEER) series of 18,317 radical prostatectomy cases reported only 0.5% of these were done for post-RT salvage, yet that small sample demonstrated an outsized proportion of toxicity for salvage cases relative to de novo radical prostatectomy. This group recorded greater than double the rate of 30-day complications, hospital stay length, 30-day readmission rate, and 6month total medical expenditure, with their relative risk of death elevated by 27 times.…”

Section: Introductionmentioning

confidence: 99%

“…10 In tertiary centers with greater experience, the complication risk was lower. 2,8,9 Nonsurgical treatments, including cryosurgery and highintensity focused ultrasound are described to have variable success and toxicity, although experience with these modalities remains fairly limited. [3][4][5][6]11 Low dose-rate (LDR) brachytherapy has also been successfully used but again with typically higher toxicity versus primary treatment.…”

Section: Introductionmentioning

confidence: 99%

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Retreatment for Local Recurrence of Prostatic Carcinoma After Prior Therapeutic Irradiation: Efficacy and Toxicity of HDR-Like SBRT

Fuller

Wurzer

Shirazi

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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Conclusions: SBRT salvage of local prostate recurrence in previously irradiated patients appears clinically feasible in this challenging group. It demonstrates favorable PSA and DFS response, typically deferring the need for salvage androgen deprivation therapy or other treatment by over 5 years, with low GU and GI toxicity. Ó 2019 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Abbreviations: ADT Z androgen deprivation therapy; EBRT Z external beam radiation therapy; RT Z radiotherapy; SBRT Z stereotactic body radiation therapy. Volume 106 Number 2 2020Local recurrent prostate cancer SBRT salvage 293

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retreatment for Local Recurrence of Prostatic Carcinoma After Prior Therapeutic Irradiation: Efficacy and Toxicity of HDR-Like SBRT

Fuller

Wurzer

Shirazi

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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“…Yutkin et al. published the only series of S‐HIFU after brachytherapy demonstrating feasibility (Table ) .…”

Section: Discussionmentioning

confidence: 99%

“…The oncological and functional outcomes of the main published series on SRP [8,9,[23][24][25][26][27], salvage re-irradiation (brachytherapy [11,28,29] and EBRT [12]) and cryotherapy [10,30], including patients initially treated with LDR brachytherapy, are presented in Table 6.…”

mentioning

confidence: 99%

Salvage high‐intensity focused ultrasound for locally recurrent prostate cancer after low‐dose‐rate brachytherapy: oncological and functional outcomes

et al. 2019

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Objectives To evaluate the oncological and functional outcomes of salvage high‐intensity focused ultrasound (S‐HIFU) for locally recurrent prostate cancer after low‐dose‐rate (LDR) brachytherapy. Patients and Methods Clinical phase II studies (2003–2015) included 50 consecutive patients with post‐brachytherapy local recurrence treated by S‐HIFU. S‐HIFU was performed with post‐external beam radiotherapy (EBRT) parameters and, since 2008, with specific post‐brachytherapy parameters. Treatments were whole‐gland ablation and, since 2009, hemi‐ablation in cases of unilateral prostate cancer. The primary objective was to assess oncological outcomes: treatment failure‐free survival, progression‐free survival (PFS), overall survival (OS), cancer‐specific survival (CSS), and metastasis‐free survival (MFS) rates. The secondary objective was to evaluate adverse events, continence, and erectile function. Kaplan–Meier analysis estimated oncological outcomes. Results In all, 13 patients were treated with post‐EBRT parameters, 37 with post‐brachytherapy parameters, 35 with whole‐gland treatment, and 15 with hemi‐ablation. The median follow‐up was 4.6 years. After S‐HIFU, the median prostate‐specific antigen level was 0.3 ng/mL. At 6 years, treatment failure‐free survival, PFS, OS, CSS, and MFS rates were 41%, 45%, 93%, 98%, and 80%, respectively. Post‐brachytherapy compared with post‐EBRT parameters reduced Grade 2–3 incontinence (34% vs 62%, P = 0.015). Incontinence, bladder outlet obstruction and Grade ≥III complications were significantly reduced with hemi‐ablation compared with whole‐gland treatment (14% vs 54%, P < 0.001; 13% vs 46%, P = 0.03; 13% vs 63%, P = 0.001; respectively). Before S‐HIFU, 25 patients had a five‐item version of the International Index of Erectile Function score of ≥17, which was maintained in 48% at 12 months. Conclusion S‐HIFU for locally recurrent prostate cancer after LDR brachytherapy is associated with favourable survival rates at a price of significant morbidity. Dedicated post‐brachytherapy parameters and hemi‐ablation improve the safety of the treatment.

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“…In case of unavailable surgical video or MRI patients were excluded from the study. Patients who underwent a salvage prostatectomy after radiation therapy 14 or who received adjuvant radiation therapy within 12 months from the surgery 15 were excluded from analysis due to a significant impact of these treatments on the continence status. In our study a patient with an International consultation incontinence modular questionnaire ‐short form (ICIQ‐SF) score of zero was defined as continent, while a patient with an ICIQ‐SF score of 10 or more was defined as incontinent 16 .…”

Section: Methodsmentioning

confidence: 99%

Identifying the relationship between postoperative urinary continence and residual urethra stump measurements in robot assisted radical prostatectomy patients

Beulens

Brinkman

Umari

et al. 2020

Robotics Computer Surgery

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Objective To investigate the feasibility of urethral stump length and width measurements in recorded videos of robot assisted radical prostatectomy procedures using the Kinovea software and to assess if these measurements could be used as predictors of postoperative urinary continence. Methods Fifty‐three patients were selected from an institutional database of 1400 cases and included in the study. All videos were analysed using the computer software ‘Kinovea’. All measurements were performed using the inserted bladder catheter as a reference point. Results The reference point (bladder catheter) was available in 33 out of 53 patients. The median surgical urethral length (SUL) was significantly higher in the continent group (1050 vs. 1294 mm, p = 0.018). The urethral width measurements did not show a difference between the groups. In order to validate the Kinovea software as an accurate tool for the measurement of the urethral stump length and width results were correlated with the magnetic resonance imaging measurements of the urethra. Conclusions The results of this study showed a significantly longer median SUL incontinent patients.

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Salvage robotic-assisted radical prostatectomy: oncologic and functional outcomes from two high-volume institutions

Abstract: sRARP is a feasible alternative for PCa recurrence. Technically the procedure is challenging and should be performed by experienced PCa surgeons. Major complications are uncommon. Continence and potency recovery is possible, but at lower rates than for non-salvage patients.

Cited by 34 publications

References 25 publications

Retreatment for Local Recurrence of Prostatic Carcinoma After Prior Therapeutic Irradiation: Efficacy and Toxicity of HDR-Like SBRT

Retreatment for Local Recurrence of Prostatic Carcinoma After Prior Therapeutic Irradiation: Efficacy and Toxicity of HDR-Like SBRT

Salvage high‐intensity focused ultrasound for locally recurrent prostate cancer after low‐dose‐rate brachytherapy: oncological and functional outcomes

Identifying the relationship between postoperative urinary continence and residual urethra stump measurements in robot assisted radical prostatectomy patients

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