Outcomes after radical prostatectomy in men receiving previous pelvic radiation for non-prostate malignancies.
OBJECTIVE
To report the perioperative and functional outcomes of nine patients treated at our institution who had radical prostatectomy (RP) after previous pelvic radiotherapy (RT) for non-prostate malignancies.


METHODS
From 1993 to 2007, nine patients had RP after external beam RT for testicular seminoma (six), anorectal cancer (two) and colon cancer (one). Clinical information was obtained from a prospective prostate cancer database.


RESULTS
RP was completed with no identifiable injury to adjacent structures in all nine patients. Four patients had significant pelvic fibrosis, and three required bilateral neurovascular bundle (NVB) resection. The NVB was preserved in the remaining six patients, four with good preoperative erectile function. However, no patient recovered erectile function after RP at a median (range) follow-up of 75 (12-172) months. Of seven men continent before RP, four required one or fewer pads daily and three were completely dry, achieving complete urinary control at a median (range) time of 7.5 (2-20) months. Two patients developed an anastomotic stricture, one being associated with concomitant ureteric stricture.


CONCLUSIONS
RP after pelvic RT for non-prostate malignancies was not associated with increased intraoperative morbidity. However, rates of anastomotic stricture, erectile dysfunction and urinary incontinence appeared to be higher than those reported after RP in men with no previous RT, and comparable with those seen in the salvage RP setting.
Masterson
Timothy A
TA
Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Wedmid
Alexei
A
Sandhu
Jaspreet S
JS
Eastham
James A
JA
D000368:Aged; D003110:Colonic Neoplasms / Q000532:radiotherapy; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000601:surgery*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012004:Rectal Neoplasms / Q000532:radiotherapy; D013736:Testicular Neoplasms / Q000532:radiotherapy; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology*