[Salvage radical prostatectomy after radiotherapy failure in localized prostatic cancer].
OBJECTIVE
The objective of this study was to evaluate salvage radical prostatectomy after failure of radiotherapy for localized prostate cancer.


METHODS
The literature published between 1984 and 2002 was reviewed by a MEDLINE search using the following key words: prostate cancer, radiotherapy, salvage radical prostatectomy.


RESULTS
A total of 404 cases of salvage radical prostatectomy were identified, including 287 radical prostatectomies and 117 radical cystoprostatectomies. Patient selection criteria for this type of surgery were: good general state with a life expectancy of at least 10 years, tumour recurrence with no signs of local or distant extension, histological evidence a minimum of 12 months after radiotherapy and PSA level less than 10 ng/ml before radiotherapy and surgery. The mean rectal injury rate was 7% (range: 0% to 28%) and the mean incontinence rate was 37% (range: 0% to 80%). Histologically, the mean rate of prostate-confined tumours was 34% (range: 20% to 60%), a mean seminal vesicle invasion rate of 36% (range: 25% to 50%) and a mean positive surgical margins rate of 36% (range: 15% to 67%). This second-line treatment was effective in terms of long-term survival, with a specific 10-year survival of 70%.


CONCLUSIONS
Radical prostatectomy after failure of radiotherapy is associated with considerable morbidity, but can achieve a good 10-year survival rate in carefully selected patients.
Rigaud
Jérôme
J
Clinique Urologique, CHU de Nantes, France.
Tiguert
Rabi
R
Fradet
Yves
Y
Bouchot
Olivier
O
D006801:Humans; D008297:Male; D018579:Patient Selection; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D016879:Salvage Therapy; D015996:Survival Rate; D017211:Treatment Failure