Document Detail

Salvage laparoscopic extraperitoneal radical prostatectomy after failed high-intensity focused ultrasound and radiotherapy for localized prostate cancer.
MedLine Citation:
PMID:  17919699     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To investigate the feasibility and efficacy of salvage endoscopic extraperitoneal radical prostatectomy (EERPE) in cases of recurrent prostate cancer after high-intensity focused ultrasound therapy (HIFU) or radiotherapy. METHODS: Nine patients underwent salvage EERPE with curative intent for biopsy-proven, locally recurrent prostate cancer. Of these 9 patients, 3 had previously undergone HIFU and 6 radiotherapy. Perioperative parameters (operation time, estimated blood loss, conversion to open surgery rate, transfusion rate, transurethral catheter time), functional outcome, and short-term oncologic outcome were reviewed. RESULTS: Mean patient age was 63.3 years (range 48 to 74 years). Mean preoperative PSA value was 12.64 ng/mL and mean prostate weight was 49.2 g. Mean blood loss was 238 mL. There was no need for conversion to open surgery or transfusion. Mean operation time was 148 minutes, and mean total transurethral catheter time was 6 days. No intraoperative complications were reported. There was no clear difference in operation difficulty between the post-HIFU and postradiotherapy EERPE. After a mean follow-up of 17 months, 7 patients were completely continent, and 2 needed 1 to 2 pads per day. Three patients were potent before the surgical treatment, but no patient reported potency postoperatively. In 1 patient a PSA relapse (1.20 ng/mL) was recognized 12 months postoperatively. CONCLUSIONS: Salvage EERPE after failed HIFU and radiation therapy is a safe and efficient method to treat locally recurrent prostate cancer. Short-term oncologic and functional outcomes are promising, but further study should be made on the long-term oncologic outcomes of this technique.
Jens-Uwe Stolzenburg; Bernard Bynens; Minh Do; Robert Rabenalt; Paraskevi F Katsakiori; Evangelos Liatsikos
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Publication Detail:
Type:  Journal Article     Date:  2007-10-24
Journal Detail:
Title:  Urology     Volume:  70     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-10     Completed Date:  2008-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  956-60     Citation Subset:  IM    
Department of Urology, Universitätsklinikum Leipzig, Leipzig, Germany.
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MeSH Terms
Middle Aged
Prostatectomy / methods*
Prostatic Neoplasms / radiotherapy,  surgery*
Salvage Therapy
Treatment Failure
Ultrasound, High-Intensity Focused, Transrectal

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