Salvage radical prostatectomy: an alternative treatment for local recurrence of radioresistant cancer.
نویسندگان
چکیده
OBJECTIVES The treatment of recurrent prostate cancer after radiotherapy or brachytherapy through radical prostatectomy has been little indicated due to the concern over the procedure's morbidity. We present the experience of our service with postradiotherapy radical prostatectomy. MATERIALS AND METHODS Between 1996 and 2002, 9 patients submitted to radiotherapy due to prostate cancer were treated with salvage surgery for locally recurrent disease. All patients had a biopsy of the prostate confirming the tumor recurrence, increase in the PSA levels and staging without evidence of a systemic disease. We have assessed the morbidity and the recurrence-free survival rate after salvage radical prostatectomy. RESULTS Preradiotherapy PSA varied from 6.2 to 50 ng/mL (mean 17.3) and clinical staging T1, T2 and T3 in 33.3%, 44.4% and 22.2% of the patients respectively. The interval for the biopsy after conforming external beam radiotherapy or brachytherapy varied from 8 to 108 months (median: 36). Four patients received antiandrogenic therapy neoadjuvant to the surgery with a mean of 7 months (1-48) after radiotherapy. From the six patients potent before the surgery, three have presented erectile dysfunction. Urinary incontinence as well as bladder neck sclerosis occurred in two patients (22.2%). Biochemical recurrence occurred in two individuals (22.2%) 12 months after the surgery. Biochemical recurrence-free survival rate was 77.8% with median follow-up time of 30 months (8-102). CONCLUSION Salvage radical prostatectomy is a safe and effective alternative for the treatment of locally recurrent prostate cancer after radiotherapy and brachytherapy.
منابع مشابه
Salvage HIFU for biopsy confirmed local prostate cancer recurrence after radical prostatectomy and radiation therapy: Case report and literature review.
High-intensity focused ultrasound (HIFU) is a treatment option for low- and intermediate-risk prostate cancer and more recently has been used as salvage therapy after failed radiation therapy. We present a case of local recurrence with biochemical failure after radical prostatectomy and salvage external beam radiation therapy with salvage HIFU without biochemical recurrence at 20 months.
متن کاملSalvage Therapy Options for Local Prostate Cancer Recurrence After Primary Radiotherapy: a Literature Review. - PubMed - NCBI
Abstract While recurrence after primary treatment of prostate cancer (PCa) is not uncommon, there is currently no consensus on the most appropriate management after radiation treatment failure. This article seeks to explore the currently utilized modalities for salvage treatment for radiorecurrent PCa. We focused our review on the oncologic outcomes and reported toxicity rates in the latest stu...
متن کاملSalvage Therapy Options for Local Prostate Cancer Recurrence After Primary Radiotherapy: a Literature Review.
PURPOSE OF REVIEW While recurrence after primary treatment of prostate cancer (PCa) is not uncommon, there is currently no consensus on the most appropriate management after radiation treatment failure. This article seeks to explore the currently utilized modalities for salvage treatment for radiorecurrent PCa. We focused our review on the oncologic outcomes and reported toxicity rates in the l...
متن کاملOncological and functional results of robotic salvage radical prostatectomy after permanent brachytherapy implants.
PURPOSE To evaluate the feasibility of robotic salvage prostatectomy for local recurrence after permanent brachytherapy implants for prostate cancer. PATIENTS AND METHODS Seven patients were operated by robotic salvage prostatectomy with or without pelvic lymph node dissection between October 2007 and March 2012, for a local recurrence after iodine 125 permanent brachytherapy implants. Local ...
متن کاملSalvage Therapy for Prostate Cancer
Biochemical recurrence after treatment of prostate cancer occurs in 30–50 % of patients. Confirming that recurrence is localized to the pelvis is challenging as PSA is nonspecific and imaging modalities are imperfect in identifying location of recurrent disease. Salvage therapy after radical prostatectomy is limited to external beam radiotherapy and androgen-deprivation therapy. After radiothe...
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ورودعنوان ژورنال:
- International braz j urol : official journal of the Brazilian Society of Urology
دوره 32 5 شماره
صفحات -
تاریخ انتشار 2006