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World Journal of Urology

, Volume 33, Issue 7, pp 965–971 | Cite as

Feasibility, safety, and efficacy of salvage radical prostatectomy after Tookad® Soluble focal treatment for localized prostate cancer

  • Souhil LebdaiEmail author
  • Arnaud Villers
  • Eric Barret
  • Cosmina Nedelcu
  • Pierre Bigot
  • Abdel-Rahmène Azzouzi
Topic Paper

Abstract

Purpose

To investigate feasibility, safety, and efficacy of salvage radical prostatectomy (RP) for recurrent prostate cancer (PCa) after focal treatment with TOOKAD® Soluble vascular-targeted photodynamic therapy (VTP).

Methods

Nineteen patients underwent RP after biopsy-proven PCa post-focal VTP. We reported: operation time, blood loss, transfusion, complications, urethral catheterization time, functional outcomes, and short-term oncologic outcomes.

Results

Median age was 64 years (58–70). Median PSA before VTP was 6.30 ng/ml (3.20–9.80). Median delay between VTP and RP was 17 months (8–48). Median blood loss was 400 ml (100–1,000). Median operation time was 150 min (90–210), median urethral catheterization time was 7 days (5–18), and median hospital stay was 7 days (4–21). There was no perioperative mortality. Three patients had related per-operative complications: one pelvic hematoma (150 cc) (Clavien IIIa), one per-operative transfusion (900 cc hemorrhage) (Clavien II), and one superficial wound infection (Clavien I). After a median follow-up of 10 months (1–46), 13 were completely continent (68 %), five needed ≤1 pad/day, and one needed 3 pads/day (Clavien I). Severe erectile dysfunction was observed before and after RP (respectively 8 and 18). Ten patients regained potency with appropriate treatment. Median postoperative PSA was 0.02 ng/ml (<0.01–0.38) and remained undetectable for 16 patients (84 %). Nine patients had positive margins and six underwent complementary radiotherapy. Positive margins were significantly associated with bilateral VTP [risk ratio = 4.3, 95 % confidence interval (1.6–11.7), p = 0.003].

Conclusion

Salvage RP after VTP treatment was feasible, safe, and efficient to treat most of the locally recurrent PCa. Short-term oncologic and functional outcomes were promising, but further studies are required.

Keywords

Salvage therapy Radical prostatectomy Prostate cancer Focal therapy WST11 TOOKAD® Soluble Vascular-targeted photodynamic therapy 

Notes

Acknowledgments

We thank Pr Guy, Pr Bouchot, Dr. Barré, Dr. Navara, and Dr. Mandron for their collaboration.

Conflict of interest

Pr Azzouzi is investigator and proctor for Steba Biotech. Pr Villers is lecturer for Steba Biotech. All other authors have no conflict of interest related to this study.

Ethical standard

Ethical and regulatory approvals were sought and obtained from the relevant national and local authorities.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Souhil Lebdai
    • 1
    Email author
  • Arnaud Villers
    • 2
  • Eric Barret
    • 3
  • Cosmina Nedelcu
    • 1
  • Pierre Bigot
    • 1
  • Abdel-Rahmène Azzouzi
    • 1
  1. 1.Urology DepartmentCHU AngersAngers Cedex 9France
  2. 2.University Hospital of LilleLilleFrance
  3. 3.Institut Mutualiste Montsouris (IMM)ParisFrance

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