World Journal of Urology

, Volume 31, Issue 6, pp 1347–1352

Salvage radical prostatectomy as management of locally recurrent prostate cancer: outcomes and complications

  • James S. Rosoff
  • Stephen J. Savage
  • Sandip M. Prasad
Topic Paper

DOI: 10.1007/s00345-013-1029-z

Cite this article as:
Rosoff, J.S., Savage, S.J. & Prasad, S.M. World J Urol (2013) 31: 1347. doi:10.1007/s00345-013-1029-z

Abstract

Purpose

Management of prostate cancer following radiation therapy remains challenging, especially for younger men or those with life expectancy greater than 10 years. We outline the efficacy, safety and adequacy of radical prostatectomy for the treatment of radiorecurrent localized prostate cancer.

Methods

A systematic review was performed in September 2012 searching MEDLINE articles from 1980 to 2012 on salvage radical prostatectomy. We excluded unpublished data and non-English-language articles.

Results

The ideal candidate for salvage radical prostatectomy (SRP) has a life expectancy greater than 10 years, a PSA < 10 ng/ml and whose initial clinical staging was T1 or T2. A prostate biopsy and imaging studies to rule out metastatic disease should be performed prior to SRP. Salvage RP has a high complication rate, but this appears to be decreasing over time. Urinary continence rates range from 36 to 81 %, whereas erectile function following SRP was generally poor with less than 30 % of men regaining adequate erectile function. Men with good erectile function prior to SRP fared better than those with pre-operative erectile dysfunction. Biochemical recurrence-free probability at 5 years ranged from 37 to 55 % and the estimated cancer-specific survival at 10 years ranged from 70 to 83 %. Minimally invasive SRP is feasible and early outcomes suggest that this approach is not inferior to open surgery.

Conclusion

SRP offers a potentially curative option with proven long-term disease-free survival in appropriately selected patients. Given the morbidity of this procedure, judicious patient selection and referral to providers experienced with salvage surgery may optimize patient outcomes.

Keywords

Salvage prostatectomy Utilization Outcomes Radiotherapy 

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • James S. Rosoff
    • 1
  • Stephen J. Savage
    • 1
    • 2
  • Sandip M. Prasad
    • 1
    • 2
  1. 1.Department of UrologyMedical University of South CarolinaCharlestonUSA
  2. 2.The Hollings Cancer CenterMedical University of South CarolinaCharlestonUSA

Personalised recommendations