title: [Palliative radical (cysto)prostatectomy in locally advanced castration-resistant prostate cancer].
abstract: BACKGROUND
  Many patients with castration-resistant prostate cancer suffer from local disease progression, mostly consisting of subvesical obstruction, gross haematuria and rectal invasion with obstructive ileus. We analysed the benefit of palliative radical surgery in this patient cohort.
  
  
  METHODS
  Between 2004 and 2010, 20 patients underwent radical surgery; 12 patients underwent radical cystoprostatectomy, 3 patients required additional rectal resection and 4 patients were treated by radical prostatectomy. One patient with a poor prognosis received an ureterocutaneostomy and a colostomy. In all other patients an ileal conduit was chosen for urinary diversion.
  
  
  RESULTS
  The reduction of symptoms could be achieved in 16 of 20 (80%) patients. The median symptom-free survival was 15.3 (6-25) months, and median survival was 20.3 (9-28) months.
  
  
  CONCLUSIONS
  With radical tumour surgery an effective local symptom control can be achieved. This individual therapeutic concept should be discussed in highly selected patients.
authors.affiliation: Urologische Klinik, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland. dpfister@ukaachen.de
authors.forename: D
authors.initials: D
authors.lastname: Pfister
authors.forename: D
authors.initials: D
authors.lastname: Porres
authors.forename: R
authors.initials: R
authors.lastname: Epplen
authors.forename: T
authors.initials: T
authors.lastname: von Erps
authors.forename: A
authors.initials: A
authors.lastname: Heidenreich
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003125:Colostomy; D003131:Combined Modality Therapy; D015653:Cystectomy / Q000379:methods*; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009919:Orchiectomy; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012086:Reoperation; D016019:Survival Analysis; D020728:Transurethral Resection of Prostate; D014547:Urinary Diversion