Salvage Radical Prostatectomy for Recurrent Prostate Cancer After Primary Nonsurgical Treatment: An Updated Systematic Review

被引:13
作者
Marra, Giancarlo [1 ,2 ]
Marquis, Alessandro [1 ,2 ]
Yanagisawa, Takafumi [3 ,4 ]
Shariat, Shahrokh F. [3 ,5 ,6 ,7 ,8 ]
Touijer, Karim [9 ]
Gontero, Paolo [1 ,2 ]
机构
[1] San Giovanni Battista Hosp, Citta Salute & Sci, Dept Surg Sci, Cso Bramante 88-90, I-10126 Turin, Italy
[2] Univ Turin, Cso Bramante 88-90, I-10126 Turin, Italy
[3] Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria
[4] Jikei Univ, Sch Med, Dept Urol, Tokyo, Japan
[5] Sechenov Univ, Inst Urol & Reprod Hlth, Moscow, Russia
[6] Charles Univ Prague, Fac Med 2, Dept Urol, Prague, Czech Republic
[7] Al Ahliyya Amman Univ, Hourani Ctr Appl Sci Res, Amman, Jordan
[8] Weill Cornell Med Coll, Dept Urol, New York, NY USA
[9] Mem Sloan Kettering Canc Ctr, Dept Urol, New York, NY USA
关键词
Prostate cancer; Recurrence; Salvage treatment; Radiotherapy; Focal therapy; Ablation; Radical prostatectomy; FUNCTIONAL OUTCOMES; PREDICTORS;
D O I
10.1016/j.euf.2023.01.013
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Salvage radical prostatectomy (sRP) has historically been associated with high morbidity, whilst recently published multicentre series suggested a trend towards improved outcomes. Hence, we performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria to investigate the oncological and functional results and morbidity of sRP. We included 20 retrospective articles comprising 4175 men. Robotic procedures were performed in 40% and nerve sparing in up to 36% of men. Postoperative continence was preserved in 40.4% of patients and erectile function in <16%. High-grade complications were described in 6.6% of patients (rectal injuries 0.9%). At final sRP pathology, surgical margins were positive in 26.1%, 32.8% had seminal vesicle invasion, and International Society of Urological Pathology grade was >3 in 26.6%. Ten-year metastasis-free survival ranged from 72% to 77% and 5-yr cancer-specific survival ranged from 86.6% to 97.7%. Salvage radical prostatectomy shows durable oncological control and morbidity improved over recent years, despite remaining significant compared to and higher than that of primary radical prostatectomy. Patient summary: Salvage radical prostatectomy (sRP) shows improving oncological control and morbidity over time. The complications associated with sRP and its functional results seem to be acceptable and are continuously improving. (c) 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:251 / 257
页数:7
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