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

Michael A. Gorin, Murugesan Manoharan, Galaxy Shah, Ahmed Eldefrawy, Mark S. Soloway

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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 radiationrecurrent 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.

Original languageEnglish
Pages (from-to)144-147
Number of pages4
JournalCentral European Journal of Urology
Volume64
Issue number3
StatePublished - Sep 9 2011

Fingerprint

Prostatectomy
Radiotherapy
Prostatic Neoplasms
Radiation
Recurrence
Urinary Incontinence
Contracture
Androgens
Fistula
Urinary Bladder
Therapeutics
Multivariate Analysis
Databases
Survival
Wounds and Injuries

Keywords

  • Biochemical recurrence
  • Prostate cancer
  • Radiation therapy
  • Salvage radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Gorin, M. A., Manoharan, M., Shah, G., Eldefrawy, A., & Soloway, M. S. (2011). Salvage open radical prostatectomy after failed radiation therapy: A single center experience. Central European Journal of Urology, 64(3), 144-147.

Salvage open radical prostatectomy after failed radiation therapy : A single center experience. / Gorin, Michael A.; Manoharan, Murugesan; Shah, Galaxy; Eldefrawy, Ahmed; Soloway, Mark S.

In: Central European Journal of Urology, Vol. 64, No. 3, 09.09.2011, p. 144-147.

Research output: Contribution to journalArticle

Gorin, MA, Manoharan, M, Shah, G, Eldefrawy, A & Soloway, MS 2011, 'Salvage open radical prostatectomy after failed radiation therapy: A single center experience', Central European Journal of Urology, vol. 64, no. 3, pp. 144-147.
Gorin, Michael A. ; Manoharan, Murugesan ; Shah, Galaxy ; Eldefrawy, Ahmed ; Soloway, Mark S. / Salvage open radical prostatectomy after failed radiation therapy : A single center experience. In: Central European Journal of Urology. 2011 ; Vol. 64, No. 3. pp. 144-147.
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AB - 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 radiationrecurrent 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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