title: Oncological and functional results of robotic salvage radical prostatectomy after permanent brachytherapy implants.
abstract: OBJECTIVE
  To evaluate the feasibility of robotic salvage prostatectomy for local recurrence after permanent brachytherapy implants for prostate cancer.
  
  
  METHODS
  Seven patients were operated by robotic salvage prostatectomy with or without pelvic lymph node dissection between October 2007 and March 2012, for a local recurrence after iodine 125 permanent brachytherapy implants. Local recurrence was proved by prostate biopsies, once biochemical relapse was diagnosed and imaging assessment performed.
  
  
  RESULTS
  The average age of a patient at the time of diagnosis was 66 years (62-71 years). The median nadir prostate specific antigen (PSA) serum concentration after brachytherapy was 1.29ng/mL (0.6-2.1ng/mL), obtained after a median of 12 months (7-21 months). The average [PSA] before robotic salvage prostatectomy was 6.60ng/mL (4.17-13.80ng/mL). [PSA] at 1 and 3 months after prostatectomy was less than 0.05ng/mL in five patients. [PSA] remained below 0.05ng/mL for six patients at 12 and 24 months. One month after robotic salvage prostatectomy, all patients had at least partial urinary incontinence. At 12 and 24 months after robotic salvage prostatectomy four patients have regained full urinary continence. In terms of erectile function at 24 months, three patients retained erectile function with possible sexual intercourse.
  
  
  CONCLUSIONS
  Robotic salvage prostatectomy appears to be a reliable treatment in terms of oncological outcome with convincing results both for urinary continence and erectile function for selected patients with local recurrence after permanent brachytherapy implants.
authors.affiliation: Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, CS 61283, 33076 Bordeaux, France. Electronic address: mathieu.orre@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Orré
authors.affiliation: Département d'urologie, clinique Saint-Augustin, 114, avenue d'Arès, 33000 Bordeaux, France.
authors.forename: T
authors.initials: T
authors.lastname: Piéchaud
authors.affiliation: Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, CS 61283, 33076 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Sargos
authors.affiliation: Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, CS 61283, 33076 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Richaud
authors.affiliation: Département d'oncologie médicale, institut Bergonié, 229, cours de l'Argonne, CS 61283, 33076 Bordeaux, France.
authors.forename: G
authors.initials: G
authors.lastname: Roubaud
authors.affiliation: Département de radiothérapie, institut Bergonié, 229, cours de l'Argonne, CS 61283, 33076 Bordeaux, France.
authors.forename: L
authors.initials: L
authors.lastname: Thomas
mesh_terms: D000368:Aged; D001918:Brachytherapy; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D020127:Recovery of Function; D065287:Robotic Surgical Procedures; D016879:Salvage Therapy; D016896:Treatment Outcome
keywords: Brachytherapy; Continence urinaire; Curiethérapie; Prostatectomie de rattrapage robotisée; Robotic salvage prostatectomy; Urinary continence