Salvage radical prostatectomy for recurrent prostate cancer following first-line nonsurgical treatment: Validation of the European Association of Urology criteria in a large, multicenter, contemporary cohort Journal Article
| Authors: | Calleris, G.; Marra, G.; Benfant, N.; Rajwa, P.; Ahmed, M.; Abreu, A.; Cacciamani, G.; Ghoreifi, A.; Ribeiro, L.; Westhofen, T.; Tourinho-Barbosa, R.; Raskin, Y.; Veerman, H.; Albisinni, S.; Smith, J. A.; Rouprêt, M.; Oderda, M.; Massari, E.; Persad, R.; Van Der Poel, H.; Joniau, S.; Sanchez-Salas, R.; Kretschmer, A.; Cathcart, P.; Gill, I.; Karnes, R. J.; Tilki, D.; Shariat, S. F.; Touijer, K.; Gontero, P. |
| Article Title: | Salvage radical prostatectomy for recurrent prostate cancer following first-line nonsurgical treatment: Validation of the European Association of Urology criteria in a large, multicenter, contemporary cohort |
| Abstract: | Salvage radical prostatectomy (sRP) is a potentially curative option for locally radiorecurrent prostate cancer (PCa) but is associated with significant morbidity. Therefore, the European Association of Urology (EAU) guidelines recommend restricting sRP to a favorable-prognosis group according to the EAU criteria, but these have been validated considering only biochemical recurrence (BCR). Our aim was to test these criteria in a large, multicenter, contemporary cohort. We retrospectively reviewed 1265 patients who underwent sRP at 14 referral centers (2000–2021), stratified by compliance with the EAU criteria. Our primary outcome was metastasis-free survival (MFS). We included 1030 men, of whom 221 (21.5%) fully met the EAU recommended criteria for sRP and 809 (78.5%) did not. The EAU-compliant group experienced more favorable pathological and functional outcomes (79% vs 63% wearing no pads at 1 yr; p < 0.001) and had significantly better MFS (90% vs 76% at 5 yr; p < 0.001), prostate-specific antigen–free survival (55% vs 38% at 5 yr; p < 0.001), and overall survival (89% vs 84% at 5 yr; p = 0.01). This was verified by Cox regression analysis for MFS (hazard ratio 1.84, 95% confidence interval 1.13–2.99; p = 0.01). We found that adherence to the EAU criteria is associated with a lower risk of BCR and, more importantly, of metastasis after surgery. Patient summary: We looked at outcomes of surgical removal of the prostate for prostate cancer recurrence after radiotherapy or other nonsurgical treatments according to whether or not patients met the European Association of Urology (EAU) criteria for this surgery. We found that men who did not meet the criteria had a higher risk of metastasis and their benefit from surgery might be significantly less than for patients who do meet the EUA criteria. © 2023 European Association of Urology |
| Keywords: | adult; cancer survival; treatment outcome; aged; retrospective studies; major clinical study; overall survival; clinical trial; cancer recurrence; patient selection; validation process; prostate specific antigen; neoplasm recurrence, local; cohort analysis; pathology; retrospective study; prostate cancer; prostatic neoplasms; prostate; prostatectomy; multicenter study; tumor recurrence; prostate tumor; urology; personal experience; salvage radical prostatectomy; local recurrence; functional outcomes; low risk population; metastasis free survival; humans; human; male; article; metastasis-free survival |
| Journal Title: | European Urology Focus |
| Volume: | 9 |
| Issue: | 4 |
| ISSN: | 2405-4569 |
| Publisher: | Elsevier B.V. |
| Date Published: | 2023-07-01 |
| Start Page: | 645 |
| End Page: | 649 |
| Language: | English |
| DOI: | 10.1016/j.euf.2023.01.006 |
| PUBMED: | 36682962 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | PDF misspells Nicole Benfante's last name -- Source: Scopus |
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