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    Management of recurrent prostate cancer after radiotherapy: long-term results from CALGB 9687 (Alliance), a prospective multi-institutional salvage prostatectomy series

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    Authors
    Mohler, James L.
    Halabi, Susan
    Ryan, Stephen T.
    Al-Daghmin, Ali
    Sokoloff, Mitchell H.
    Steinberg, Gary D.
    Sanford, Ben L.
    Eastham, James A.
    Walther, Philip J.
    Morris, Michael J.
    Small, Eric J.
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    UMass Chan Affiliations
    Department of Urology
    Document Type
    Journal Article
    Publication Date
    2019-05-01
    Keywords
    Male Urogenital Diseases
    Neoplasms
    Oncology
    Surgery
    Surgical Procedures, Operative
    Therapeutics
    
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    Link to Full Text
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494708/
    Abstract
    BACKGROUND: To evaluate efficacy and morbidity prospectively in a contemporary multi-institutional salvage radical prostatectomy (SRP) series. METHODS: Forty-one men were enrolled between 1997 and 2006, who suffered biopsy-proven recurrent prostate cancer (CaP) after receiving > /= 60c Gy radiation as primary treatment for cT1-2NXM0 disease. Surgical morbidity, quality of life, biochemical progression-free survival (BPFS) and overall survival (OS) were evaluated. RESULTS: Twenty-four men had undergone external beam radiotherapy, 11 brachytherapy, and six both. Median time between radiation and SRP was 64 months. Median age at SRP was 64 years. Pathologic staging revealed 44% pT2, 54% pT3, and 3% pT4. Surgical margins were positive in 17 and 88% were pN0. Twenty-two percent required intraoperative blood transfusion. Three rectal and one obturator nerve injuries occurred. Seventeen of 38 evaluable patients (45%) had urinary incontinence ( > /= 3 pads/day) prior to SRP; 88% reported urinary incontinence at 6 months, 85% at 12 months, 63% at 24 months after SRP. Furthermore, 37% of men reported impotence prior to SRP; 78% reported impotence at 6 months, 82% at 12 months, and 44% at 24 months after SRP. The 2-, 5- and 10-year BPFS rates were 51, 39, and 33% respectively; the 2-, 5- and 10-year OS rates were 100, 89, and 52%, respectively, at median follow-up 91 months. CONCLUSIONS: Modern surgical techniques continue to be associated with significant peri-operative complication rates. Nevertheless, SRP may benefit carefully selected patients through durable oncologic control.
    Source

    Prostate Cancer Prostatic Dis. 2019 May;22(2):309-316. doi: 10.1038/s41391-018-0106-1. Epub 2018 Nov 1. Link to article on publisher's site

    DOI
    10.1038/s41391-018-0106-1
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/41071
    PubMed ID
    30385835
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1038/s41391-018-0106-1
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