Salvage robotic prostatectomy for radio recurrent prostate cancer: technical challenges and outcome analysis

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Arquivos
art_ZARGAR_Salvage_robotic_prostatectomy_for_radio_recurrent_prostate_cancer_2017.PDF (1.9 MB)
Citações na Scopus
35
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
EDIZIONI MINERVA MEDICA
Autores
ZARGAR, Homayoun
LAMB, Alastair D.
ROCCO, Bernardo
PORPIGLIA, Francesco
LIATSIKOS, Evangelos
DAVIS, John
POW-SANG, Julio M.
PATEL, Vipul R.
MURPHY, Declan G.
Citação
MINERVA UROLOGICA E NEFROLOGICA, v.69, n.1, p.26-37, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
INTRODUCTION: The published data on salvage robot assisted radical prostatectomy (sRARP) is limited. Our aim was to perform a systematic review of the literature on sRARP after radiation failure in patients with prostate cancer and systematically analyse the available evidence for operative and oncological outcomes. EVIDENCE ACQUISITION: A systematic review of the literature using Pubmed, Scopus, Cochrane library and ScienceDirect databases was performed in June 2016 using medical subject headings and free-text protocol. The search was conducted by applying the following search terms: salvage therapy, salvage, prostatectomy and robotics. EVIDENCE SYNTHESIS: We report on ten case series including 197 men undergoing sRARP after varying modalities of radiotherapy. Over two thirds are recurrence free at the time of follow-up but with continence rates of only 60% and potency rates of only 26%. Complications requiring intervention are few at 16% though higher than primary RARP. CONCLUSIONS: sRARP is increasingly acceptable as a treatment modality to be offered to men who fail initial radiation treatment but should be accompanied by appropriate counselling regarding the potential functional outcomes and complications. Series with longer follow-up will be helpful to assess the durability of oncological outcomes while improvements in patient selection and adaption of meticulous surgical technique around the apex could improve continence rates. The concept of concomitant extended PLND remains an issue for debate and the experience with this approach at the time of sRARP and its benefit need further scrutiny.
Palavras-chave
Prostatectomy, Surgery, computer-assisted, Prostatic neoplasms, Biochemical processes, Radiotherapy
URI
https://observatorio.fm.usp.br/handle/OPI/20206
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - ODS/03