Pilot study of salvage laparoscopic prostatectomy for the treatment of recurrent prostate cancer Journal Article

Authors: Ahallal, Y.; Shariat, S. F.; Chade, D. C.; Mazzola, C.; Reuter, V. E.; Sandhu, J. S.; Laudone, V. P.; Touijer, K. A.; Guillonneau, B. D.
Article Title: Pilot study of salvage laparoscopic prostatectomy for the treatment of recurrent prostate cancer
Abstract: OBJECTIVE To evaluate feasibility, safety and oncological efficacy of salvage laparoscopic radical prostatectomy for pathology-proven biochemical recurrence after primary radiation therapy or cryotherapy for prostate cancer. MATERIALS AND METHODS This retrospective pilot study examined 15 patients from 2004 to 2010 with biochemical recurrence after external beam radiation therapy (N= 8), brachytherapy (N= 6) or cryotherapy (N= 1). Patients were treated with salvage laparoscopic radical prostatectomy (11 conventional, four robotic-assisted) with bilateral pelvic dissection. RESULTS Median duration of surgery was 235 min. None of the following occurred: conversion to open surgery, transfusion, urethrovesical stenosis or perioperative or postoperative mortality. One patient presented with a rectal injury, repaired using uninterrupted sutures and a colostomy. One patient had anastomotic leak treated with prolonged Foley catheterization. Pathological stage was pT2a in three, pT2b in three, pT3a in four, pT3b in three and pT4 in two patients; two patients had nodal metastasis. Within an 8-month median follow-up, 11 patients were disease-free and three had persistent postoperative prostate-specific antigen (PSA) elevation; the remaining patient experienced PSA recurrence after 21 months. Seven patients achieved continence (no pads) by 8.4 months (median), one patient manifested severe incontinence corrected by implanting an artificial sphincter, and seven patients with a 12.6-month mean follow-up continued to need one or two pads per day. Erectile dysfunction was present in five patients before surgery and in 14 patients after surgery. CONCLUSION Salvage laparoscopic radical prostatectomy seems to offer a safe therapeutic alternative for patients failing primary radiation or cryotherapy. However, larger studies with longer-term data are required. © 2010 BJU INTERNATIONAL.
Keywords: adult; clinical article; human tissue; aged; mortality; salvage therapy; cancer staging; recurrent cancer; follow up; prostate specific antigen; radiotherapy; retrospective study; hematuria; prostate cancer; prostatic neoplasms; length of stay; feasibility study; pilot study; prostatectomy; operation duration; urinary tract infection; brachytherapy; safety; clinical effectiveness; robotics; external beam radiotherapy; postoperative hemorrhage; erectile dysfunction; colostomy; cryotherapy; laparoscopic prostatectomy; rectum injury; balloon catheter; salvage laparoscopic prostatectomy; suture
Journal Title: BJU International
Volume: 108
Issue: 5
ISSN: 1464-4096
Publisher: Wiley Blackwell  
Date Published: 2011-01-01
Start Page: 724
End Page: 728
Language: English
DOI: 10.1111/j.1464-410X.2010.09924.x
PROVIDER: scopus
PUBMED: 21166755
PMCID: PMC4254701
Notes: --- - "Export Date: 3 October 2011" - "CODEN: BJINF" - "Source: Scopus"
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MSK Authors
  1. Jaspreet Sandhu
    98 Sandhu
  2. Vincent Laudone
    59 Laudone
  3. Daher Chade
    19 Chade
  4. Abdelkrim Karim Touijer
    190 Touijer
  5. Shahrokh Shariat
    67 Shariat
  6. Clarisse Mazzola
    16 Mazzola
  7. Victor Reuter
    913 Reuter