Salvage radical prostatectomy after radiation therapy and brachytherapy.
Local recurrence after any type of radiation therapy presents the clinician with a significant challenge. If there is no evidence of metastatic disease, patients can be offered a potentially curative salvage prostatectomy. To qualify for such surgery, patients should be at least 12 months from the completion of radiation and have at least a 10-year life expectancy; ideally, they will have a serum prostate specific antigen concentration <10 ng/mL and a Gleason score of 7 or less. Perioperative complications are substantial, with urinary incontinence rates of 40% to 50% and rectal injury rates of 10% to 15%. Long-term disease-free survival rates of 30% to 40% can be expected.
Department of Urology, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA. RussoP@MSKCC.org
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D001918:Brachytherapy; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D016879:Salvage Therapy