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Outcomes after salvage radical prostatectomy and first-line radiation therapy or HIFU for recurrent localized prostate cancer: Results from a multicenter study

World Journal of Urology Aug 10, 2019

Clery R, Grande P, Seisen T, et al. - Data from nine French referral centers on individuals treated with salvage prostatectomy (sRP) between 2005 and 2017 were gathered by the experts in order to evaluate outcomes following sRP in a series of patients with localized PCa and that had received radiation therapy or high-intensity focused ultrasound (HIFU) as a first-line treatment. First-line treatments were external beam-radiation therapy, brachytherapy and, HIFU for 30, 10, and 15, respectively. Median (IQR) PSA at diagnosis and at nadir was 6.4 ng/mL and 1.9 ng/mL, respectively, and median (IQR) to first BCR was 13 months. Forty-four and 11 of 55 patients received robot-assisted salvage radical prostatectomy and salvage retropubic radical prostatectomy, respectively. Restoration of continence was accomplished in 90% of preoperatively continent individuals and 24% that had received nerve-sparing (NS) procedures were potent following surgery. The most prevalent complication was prolonged catheterization because of anastomotic leakage. Predictors for BCR were age, preoperative clinical-stage, NS procedure, and a pathological Gleason score. Hence, sRP was safe, likely, and efficient using either an open or robot-assisted strategy, in skilled hands. Moreover, age, preoperative clinical-stage, NS procedure, and pathological GS were related to BCR following sRP.
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