[Locally recurrent prostate cancer following radiation therapy: radical salvage prostatectomy].
Radical salvage prostatectomy represents a secondary local treatment with curative intent in patients with organ-confined prostate cancer (PC) recurrences following radiation therapy. Preoperative risk factors predicting organ-confined disease are initial low dose rate (LDR) brachytherapy, preoperative Gleason biopsy score<or=6, <or=50% biopsy cores involved with cancer, and a prostate-specific antigen (PSA) doubling time>12 months. Metastatic disease should be ruled out preoperatively by skeletal scintigraphy, abdominal computed tomography or magnetic resonance imaging, and/or choline-PET/CT. Functionality of the lower urinary tract needs to be preoperatively evaluated by urethrocystoscopy and urodynamics. With appropriate patient selection, oncological control can be achieved in 80% of patients. A continence rate of 83%-96% depending on the type of previous radiation therapy is achievable.
Heidenreich
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Klinik für Urologie, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany. aheidenreich@ukaachen.de
Thüer
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Pfister
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D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D001918:Brachytherapy; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011183:Postoperative Complications / Q000209:etiology; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D011879:Radiotherapy Dosage; D016879:Salvage Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
Lokales Prostatakarzinomrezidiv nach Strahlentherapie: Radikale Salvageprostatektomie.