Salvage Radical Prostatectomy Offers Good Long-Term Outcomes

Minimally invasive surgery is associated with a lower incidence of bladder neck contracture.
Minimally invasive surgery is associated with a lower incidence of bladder neck contracture.

SAN DIEGO—Salvage radical prostatectomy (SRP) offers good long-term oncologic outcomes among patients who experience recurrence of prostate cancer (PCa) after radiotherapy, data presented at the American Urological Association's 2016 annual meeting.

Antoni Vilaseca, MD, and colleagues at Memorial Sloan-Kettering Cancer Center in New York, studied 251 men with a median age of 65 years who underwent SRP for biopsy-proven radiorecurrent PCa after external beam radiation therapy, brachytherapy, or both. Of these, 221 underwent open SRP and 30 had minimally invasive surgery (MIS). In addition to long-term oncologic outcomes of SRP, the investigators looked at whether MIS can reduce the incidence of bladder neck contracture (BNC).

The 5- and 10-year cancer-specific survival rates were 92% and 78%, respectively, and the 5- and 10-year overall survival rates were 87% and 64%, respectively, the investigators reported. The 1- and 3-year BNC-free survival rates were 81% and 73%, respectively. Patients who underwent MIS had significantly better BNC-free survival compared with those who had open surgery.

Extraprostatic extension, lymph node invasion, seminal vesicle invasion, and positive surgical margins were present in 69%, 22%, 32%, and 17% of patients, respectively. Fifty patients died, 27 from PCa.

“Although functional outcomes and complications are worse in the salvage treatment setting,” the authors concluded in a poster presentation, “among patients undergoing SRP, minimally invasive compared to open techniques is associated with better BNC-free survival.”

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