title: [Salvage radical prostatectomy for brachytherapy failure: preliminary results].
abstract: OBJECTIVE
  Analysis of preliminary results in six patients operated by second-line (salvage) radical prostatectomy for local recurrence after low-dose brachytherapy.
  
  
  METHODS
  Since January 2009, six patients had an open salvage radical prostatectomy with a lymph node dissection and without neurovascular bundles preservation for a low-dose I125 brachytherapy failure. Local recurrence was confirmed by trans-rectal biopsy or TURP. All the patients had PSA increase or lower urinary tract symptoms. Bone scan and pelvis MRI were performed to detect a locally advanced disease, a lymph node involvement or the presence of bone metastasis. Pathology reports and PSA level at 1, 3, 6 and 12 months were analyzed.
  
  
  RESULTS
  Salvage radical prostatectomy with lymph node dissection was performed in all patients without major complications. The PSA level was below 0.1 ng/mL in five out of six patients at 1 and 3 months. The only case of persistent PSA is treated by androgen deprivation in a pT3b N1 patient.
  
  
  CONCLUSIONS
  Salvage radical prostatectomy after brachytherapy failure was feasible with a limited perioperative morbidity. This second-line curative treatment in a selected group of patients should be kept in mind. Our early results looked promising.
authors.affiliation: Service de chirurgie urologique, nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Saeedi
authors.affiliation: Service de chirurgie urologique, nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Pop
authors.affiliation: Service de chirurgie urologique, nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France. Electronic address: didier.jacqmin@chru-strasbourg.fr.
authors.forename: D
authors.initials: D
authors.lastname: Jacqmin
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D005240:Feasibility Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy / Q000601:surgery*; D016879:Salvage Therapy; D017211:Treatment Failure
chemical_list: D017430:Prostate-Specific Antigen
keywords: Brachytherapy failure; Prostatectomie; Prostatectomy; Échec de curiethérapie