title: Robot-assisted radical prostatectomy for the treatment of radiation-resistant prostate cancer: surgical, oncological and short-term functional outcomes.
abstract: OBJECTIVE
  The objective of this study was to assess the surgical, oncological and short-term functional outcomes in patients undergoing salvage robot-assisted radical prostatectomy (SRARP) for the treatment of radiation-resistant prostate cancer.
  
  
  METHODS
  The records of 3,500 men who underwent RARP from February 2006 to July 2011 were retrospectively reviewed. All peri- and postoperative data were recorded prospectively in our database. A total of 13 patients (0.37%) who had undergone SRARP for the treatment of radiation-resistant prostate cancer were identified.
  
  
  RESULTS
  The primary treatment was external beam radiotherapy in 7 patients (53.8%) and brachytherapy in 6 patients (46.2%). The interval from radiotherapy to biochemical recurrence (BCR) varied from 12 to 108 months (median 48.9). Neurovascular bundle preservation was performed in 3 patients (23.1%). No intraoperative or major complications were encountered. Minor complications were encountered in 4 patients (30.7%). At 12 months, 7 patients were continent (53.8%), 3 exhibited mild incontinence (23.1%) and 3 (23.1%) were incontinent. Regarding potency, none of the patients were potent at 6 months, but 3 patients (23.1%) were potent at 1 year. Regarding BCR, 3 of the patients (23.1%) never reached a prostate-specific antigen nadir of zero, and during the follow-up period only 3 patients (23.1%) exhibited BCR. No disease-specific mortality was evident during follow-up.
  
  
  CONCLUSIONS
  Although early in its development, it appears that SRARP is technically feasible and offers satisfactory surgical, oncological and short-term functional outcomes.
authors.affiliation: Department of Urology and Pediatric Urology, Prostate Center Northwest, St. Antonius Hospital, Gronau, Germany.
authors.forename: Vahudin
authors.initials: V
authors.lastname: Zugor
authors.forename: Apostolos P
authors.initials: AP
authors.lastname: Labanaris
authors.forename: Daniel
authors.initials: D
authors.lastname: Porres
authors.forename: Axel
authors.initials: A
authors.lastname: Heidenreich
authors.forename: Jorn H
authors.initials: JH
authors.lastname: Witt
mesh_terms: D000368:Aged; D001918:Brachytherapy; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D011836:Radiation Tolerance; D012189:Retrospective Studies; D012371:Robotics; D016879:Salvage Therapy; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D013997:Time Factors; D017211:Treatment Failure