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Salvage open radical prostatectomy after failed radiation therapy: a single center experience

INTRODUCTION: Currently there is no universally accepted approach for the management of radiation-recurrent prostate cancer. The aim of this study was to detail our experience performing salvage radical prostatectomy for patients who failed primary treatment of prostate cancer with radiation therapy...

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Autores principales: Gorin, Michael A., Manoharan, Murugesan, Shah, Galaxy, Eldefrawy, Ahmed, Soloway, Mark S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Polish Urological Association 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921722/
https://www.ncbi.nlm.nih.gov/pubmed/24578882
http://dx.doi.org/10.5173/ceju.2011.03.art9
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author Gorin, Michael A.
Manoharan, Murugesan
Shah, Galaxy
Eldefrawy, Ahmed
Soloway, Mark S.
author_facet Gorin, Michael A.
Manoharan, Murugesan
Shah, Galaxy
Eldefrawy, Ahmed
Soloway, Mark S.
author_sort Gorin, Michael A.
collection PubMed
description INTRODUCTION: Currently there is no universally accepted approach for the management of radiation-recurrent prostate cancer. The aim of this study was to detail our experience performing salvage radical prostatectomy for patients who failed primary treatment of prostate cancer with radiation therapy. MATERIAL AND METHODS: We retrospectively queried our institutional database of radical prostatectomy cases for patients who underwent salvage surgery for radiation-recurrent prostate cancer. Patients were assessed for the risk of complications and oncologic outcomes following salvage surgery. RESULTS: Twenty-four patients with a mean age of 65 years (range 51-74) underwent salvage radical prostatectomy. Fourteen of these patients (58%) received androgen deprivation therapy prior to surgery. Intraoperatively, mean blood loss was estimated at 415 mL (range 100-1000) and 19 (79%) patients received autologous blood. No patient required an allogeneic transfusion or experienced a rectal injury. Postoperative bladder neck contracture and urinary incontinence developed in 17% and 39% of men, respectively. Two (29%) of seven patients remained potent after salvage surgery. No patient developed a fistula. Overall and recurrence-free survival at 5-years was 90% and 39%, respectively. On multivariate analysis, extracapsular extension was the only significant predictor of biochemical recurrence (HR 6.9, 95% CI 1.9-25.3 p = 0.003). CONCLUSION: In carefully selected patients, salvage radical prostatectomy for radiation-recurrent prostate cancer is a treatment option with acceptable oncologic outcomes and a moderate complication rate.
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spelling pubmed-39217222014-02-27 Salvage open radical prostatectomy after failed radiation therapy: a single center experience Gorin, Michael A. Manoharan, Murugesan Shah, Galaxy Eldefrawy, Ahmed Soloway, Mark S. Cent European J Urol Urological Oncology INTRODUCTION: Currently there is no universally accepted approach for the management of radiation-recurrent prostate cancer. The aim of this study was to detail our experience performing salvage radical prostatectomy for patients who failed primary treatment of prostate cancer with radiation therapy. MATERIAL AND METHODS: We retrospectively queried our institutional database of radical prostatectomy cases for patients who underwent salvage surgery for radiation-recurrent prostate cancer. Patients were assessed for the risk of complications and oncologic outcomes following salvage surgery. RESULTS: Twenty-four patients with a mean age of 65 years (range 51-74) underwent salvage radical prostatectomy. Fourteen of these patients (58%) received androgen deprivation therapy prior to surgery. Intraoperatively, mean blood loss was estimated at 415 mL (range 100-1000) and 19 (79%) patients received autologous blood. No patient required an allogeneic transfusion or experienced a rectal injury. Postoperative bladder neck contracture and urinary incontinence developed in 17% and 39% of men, respectively. Two (29%) of seven patients remained potent after salvage surgery. No patient developed a fistula. Overall and recurrence-free survival at 5-years was 90% and 39%, respectively. On multivariate analysis, extracapsular extension was the only significant predictor of biochemical recurrence (HR 6.9, 95% CI 1.9-25.3 p = 0.003). CONCLUSION: In carefully selected patients, salvage radical prostatectomy for radiation-recurrent prostate cancer is a treatment option with acceptable oncologic outcomes and a moderate complication rate. Polish Urological Association 2011-09-06 2011 /pmc/articles/PMC3921722/ /pubmed/24578882 http://dx.doi.org/10.5173/ceju.2011.03.art9 Text en Copyright by Polish Urological Association http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Urological Oncology
Gorin, Michael A.
Manoharan, Murugesan
Shah, Galaxy
Eldefrawy, Ahmed
Soloway, Mark S.
Salvage open radical prostatectomy after failed radiation therapy: a single center experience
title Salvage open radical prostatectomy after failed radiation therapy: a single center experience
title_full Salvage open radical prostatectomy after failed radiation therapy: a single center experience
title_fullStr Salvage open radical prostatectomy after failed radiation therapy: a single center experience
title_full_unstemmed Salvage open radical prostatectomy after failed radiation therapy: a single center experience
title_short Salvage open radical prostatectomy after failed radiation therapy: a single center experience
title_sort salvage open radical prostatectomy after failed radiation therapy: a single center experience
topic Urological Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921722/
https://www.ncbi.nlm.nih.gov/pubmed/24578882
http://dx.doi.org/10.5173/ceju.2011.03.art9
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