Salvage radical prostatectomy for radiorecurrent prostate cancer: indications and results

A rise in the incidence of radiorecurrent prostate cancer is to be expected, since approximately one third of early prostate cancer cases are nowadays treated with a radiotherapy modality. One possibility in treating radiorecurrent prostate cancer is salvage prostatectomy. Our objective was to look into our own experience with salvage radical prostatectomy and to analyse outcome and morbidity.

A computer search through our hospital database identified 11 patients who underwent a salvage radical prostatectomy for radiorecurrent cancer over the last 15 years. All data were retrospectively analysed and confronted with the literature.

Although the surgery was mostly difficult, there were no intraoperative complications. Bladder neck stricture is the most common postoperative complication (18%). Continence rates are worse than in classical radical prostatectomy. All patients lost potency, since no attempt was made to spare the neurovascular bundles. With a mean follow-up of 6.9 years, biochemical disease-free survival rates was 55%, while overall and cancer-specific survival was 91%.

While most patients with radiorecurrent prostate cancer will be treated by many experts with hormonal therapy, a salvage radical prostatectomy can give a second chance for cure in carefully selected patients.