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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-06

AUTHORS

Giorgio Calleris, Giancarlo Marra, Ettore Dalmasso, Marco Falcone, Robert Jeffrey Karnes, Alessandro Morlacco, Marco Oderda, Rafael Sanchez-Salas, Francesco Soria, Paolo Gontero

ABSTRACT

PURPOSE: Salvage radical prostatectomy (sRP) represents a curative option for prostate cancer (PCa) biochemical recurrence (BCR) after radiation therapy (RT). In this review, we aimed to outline the contemporary results and use of sRP. METHODS: A web search was performed on the Ovid platform using Embase and Medline databases from January 2010 using pre-defined search terms. Web search was implemented by manual search. Oncological and functional outcomes and complications were summarized using standard classification systems, when feasible. RESULTS: sRP is currently underused, being chosen for radio-recurrent PCa treatment in around 1% of the cases. Surgery is complex due to radiation-induced tissue changes making posterior planes and apex dissection particularly challenging. Patient selection is paramount to maximize the oncological benefit. Most series report a BCR-free survival > 60%, mainly at the end of a short- to intermediate-term follow-up. Five-year progression-free survival is nearly 50% and 5-year cancer-specific survival rates are around 90%. Major peri-operative complications, anastomotic leaks and strictures, still more frequent than in a primary RP setting, have been steering towards more acceptable rates in recent years, when compared to historical series. Continence rates are widely variable, often in between 39 and 60%. Potency remains difficult to recover. CONCLUSIONS: sRP represents a curative option with promising short- to medium-term oncological results and acceptable side effects, in high-volume institutions. In appropriately selected patients, the procedure should not be underused due to the fear of poor functional outcomes and/or complications. Prospective studies are needed to assess the long-term outcomes and to further refine patient selection criteria. More... »

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-019-02749-z

DOI

http://dx.doi.org/10.1007/s00345-019-02749-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113283297

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30955047


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