Salvage Radical Prostatectomy for Recurrent Prostate Cancer: A Systematic Review (French ccAFU)

Author:

Saouli Amine1,Ruffion Alain234,Dariane Charles5ORCID,Barret Eric6,Fiard Gaëlle47ORCID,Hankard Gaelle Fromont8,Créhange Gilles9,Roubaud Guilhem10,Beauval Jean Baptiste11,Brureau Laurent6,Renard-Penna Raphaëlle12,Gauthé Mathieu4ORCID,Baboudjian Michael13ORCID,Ploussard Guillaume14ORCID,Rouprêt Morgan15

Affiliation:

1. Department of Urology, CHU Souss Massa, Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir 80000, Morocco

2. Service D’urologie Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69002 Lyon, France

3. Équipe 2, Centre D’innovation en Cancérologie de Lyon (EA 3738 CICLY), Faculté de Médecine Lyon Sud, Université Lyon 1, 69002 Lyon, France

4. Comité de Cancérologie de l’Association Française d’Urologie, Groupe Prostate, Maison de l’Urologie, 11, Rue Viète, 75017 Paris, France

5. Department of Urology, Hôpital Européen Georges-Pompidou, AP-HP, Paris University, U1151 Inserm-INEM, F-75015 Paris, France

6. Department of Urology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014 Paris, France

7. Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, 38400 Grenoble, France

8. Department of Pathology, CHRU Tours, 37000 Tours, France

9. Department of Radiotherapy, Institut Curie, 75005 Paris, France

10. Department of Medical Oncology, Institut Bergonié, 33000 Bordeaux, France

11. Department of Urology, CHU Rennes, CIC 1414 Rennes, France

12. AP-HP, Radiology, Pitie-Salpetriere Hospital, Sorbonne University, 75013 Paris, France

13. Service D’urologie et de Transplantation Rénale, CHU La Conception, 13005 Marseille, France

14. Department of Urology, La Croix du Sud Hôpital, 31130 Quint-Fonsegrives, France

15. GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, Sorbonne University, 75013 Paris, France

Abstract

The aim of this study was to systematically review the current evidence regarding the oncological and functional outcomes of salvage radical prostatectomy (sRP) for recurrent prostate cancer. A systematic review was conducted throughout September 2022 using the PubMed, Science Direct, Scopus, and Embase databases. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify eligible studies. A total of 55 studies (3836 patients) met our eligibility criteria. The vast majority of men included had radiation therapy (including brachytherapy) as their first-line treatment (n = 3240, 84%). Other first-line treatments included HIFU (n = 338, 9%), electroporation (n = 59, 2%), proton beam therapy (n = 54, 1.5%), cryotherapy (n = 34, 1%), focal vascular targeted photodynamic therapy (n = 22, 0.6%), and transurethral ultrasound ablation (n = 19, 0.5%). Median preoperative PSA, at the time of recurrence, ranged from 1.5 to 14.4 ng/mL. The surgical approach was open in 2300 (60%) cases, robotic in 1465 (38%) cases, and laparoscopic in 71 (2%) cases. Since 2019, there has been a clear increase in robotic versus conventional surgery (1245 versus 525 cases, respectively). The median operative time and blood loss ranged from 80 to 297 min and 75 to 914 mL, respectively. Concomitant lymph node dissection was performed in 2587 cases (79%). The overall complication rate was 34%, with a majority of Clavien grade I or II complications. Clavien ≥ 3 complications ranged from 0 to 64%. Positive surgical margins were noted in 792 cases (32%). The median follow-up ranged from 4.6 to 94 months. Biochemical recurrence after sRP ranged from 8% to 51.5% at 12 months, from 0% to 66% at 22 months, and from 48% to 59% at 60 months. The specific and overall survival rates ranged from 13.4 to 98% and 62 to 100% at 5 years, respectively. Urinary continence was maintained in 52.1% of cases. sRP demonstrated acceptable oncological outcomes. These results, after sRP, are influenced by several factors, and above all by pre-treatment assessment, including imaging, with the development of mpMRI and metabolic imaging. Our results demonstrated that SRP can be considered a suitable treatment option for selected patients, but the level of evidence remains low.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Reference69 articles.

1. Recent Global Patterns in Prostate Cancer Incidence and Mortality Rates;Culp;Eur. Urol.,2020

2. National trends in management of localized prostate cancer: A population based analysis 2004–2013;Chen;Prostate,2018

3. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. Part II-2020 Update: Treatment of Relapsing and Metastatic Prostate Cancer;Cornford;Eur. Urol.,2021

4. Radiorecurrent prostate cancer: An emerging and largely mismanaged epidemic;Jones;Eur. Urol.,2011

5. Salvage robotic-assisted radical prostatectomy (SRALP) for treatment of radio-recurrent prostate cancer: Description of technique and multi-institutional outcomes;Coelho;J. Endourol.,2010

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3