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Salvage radical prostatectomy: an alternative treatment for local recurrence of radioresistant cancer
Dall'Oglio, Marcos F; Barreto, Francualdo; Paranhos, Mario; Nesrallah, Adriano; Nesrallah, Luciano; Srougi, Miguel.
  • Dall'Oglio, Marcos F; University of Sao Paulo. Faculty of Medicine. Department of Urology. Sao Paulo. BR
  • Barreto, Francualdo; University of Sao Paulo. Faculty of Medicine. Department of Urology. Sao Paulo. BR
  • Paranhos, Mario; University of Sao Paulo. Faculty of Medicine. Department of Urology. Sao Paulo. BR
  • Nesrallah, Adriano; University of Sao Paulo. Faculty of Medicine. Department of Urology. Sao Paulo. BR
  • Nesrallah, Luciano; University of Sao Paulo. Faculty of Medicine. Department of Urology. Sao Paulo. BR
  • Srougi, Miguel; University of Sao Paulo. Faculty of Medicine. Department of Urology. Sao Paulo. BR
Int. braz. j. urol ; 32(5): 550-556, Sept.-Oct. 2006. graf, tab
Article in English | LILACS | ID: lil-439386
ABSTRACT

OBJECTIVES:

The treatment of recurrent prostate cancer after radiotherapy or brachytherapy through radical prostatectomy has been little indicated due to the concern over the procedure's morbidity. We present the experience of our service with postradiotherapy radical prostatectomy. MATERIALS AND

METHODS:

Between 1996 and 2002, 9 patients submitted to radiotherapy due to prostate cancer were treated with salvage surgery for locally recurrent disease. All patients had a biopsy of the prostate confirming the tumor recurrence, increase in the PSA levels and staging without evidence of a systemic disease. We have assessed the morbidity and the recurrence-free survival rate after salvage radical prostatectomy.

RESULTS:

Preradiotherapy PSA varied from 6.2 to 50 ng/mL (mean 17.3) and clinical staging T1, T2 and T3 in 33.3 percent, 44.4 percent and 22.2 percent of the patients respectively. The interval for the biopsy after conforming external beam radiotherapy or brachytherapy varied from 8 to 108 months (median 36). Four patients received antiandrogenic therapy neoadjuvant to the surgery with a mean of 7 months (1-48) after radiotherapy. From the six patients potent before the surgery, three have presented erectile dysfunction. Urinary incontinence as well as bladder neck sclerosis occurred in two patients (22.2 percent). Biochemical recurrence occurred in two individuals (22.2 percent) 12 months after the surgery. Biochemical recurrence-free survival rate was 77.8 percent with median follow-up time of 30 months (8-102).

CONCLUSION:

Salvage radical prostatectomy is a safe and effective alternative for the treatment of locally recurrent prostate cancer after radiotherapy and brachytherapy.
Subject(s)
Full text: Available Index: LILACS (Americas) Main subject: Prostatectomy / Prostatic Neoplasms / Salvage Therapy / Neoplasm Recurrence, Local Type of study: Observational study / Prognostic study Limits: Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2006 Type: Article Affiliation country: Brazil Institution/Affiliation country: University of Sao Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Prostatectomy / Prostatic Neoplasms / Salvage Therapy / Neoplasm Recurrence, Local Type of study: Observational study / Prognostic study Limits: Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2006 Type: Article Affiliation country: Brazil Institution/Affiliation country: University of Sao Paulo/BR