title: Current status of salvage robot-assisted laparoscopic prostatectomy for radiorecurrent prostate cancer.
abstract: Radiation therapy (RT) is one of the treatment options for prostate cancer (PCa). Transperineal low-dose rate brachytherapy (BT) is another safe and effective technique for low-risk PCa. Recurrence after RT for localized PCa can be defined by a PSA value of 2 ng/mL above the nadir after RT, and biochemical recurrence (BCR) rate after RT is 40-60 %. In case of radiorecurrent PCa, treatment options include salvage radical prostatectomy (RP), cryotherapy, high-intensity focused ultrasound (HIFU), and salvage BT. Only salvage RP has cancer control results for over 10-year follow-up in a substantial portion of patients (30-40 %). However, salvage RP is technically demanding, and experienced surgeons are needed; in fact, RT-induced cystitis, fibrosis, and tissue plane obliteration can lead to significant complications, such as rectal injuries, anastomotic stricture, and urinary incontinence. This review describes indications, oncologic and functional outcomes, surgical techniques, and complications of salvage robot-assisted RP.
authors.affiliation: Clinica Urologica I, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Rocco
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cozzi
authors.forename: Matteo Giulio
authors.initials: MG
authors.lastname: Spinelli
authors.forename: Angelica
authors.initials: A
authors.lastname: Grasso
authors.forename: Daniela
authors.initials: D
authors.lastname: Varisco
authors.forename: Rafael F
authors.initials: RF
authors.lastname: Coelho
authors.forename: Vipul R
authors.initials: VR
authors.lastname: Patel
mesh_terms: D001918:Brachytherapy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012371:Robotics; D016879:Salvage Therapy; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology