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

Amine Saouli1, Alain Ruffion2,3,4, Charles Dariane5

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

Cancers
|November 25, 2023
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Summary

Salvage radical prostatectomy (sRP) offers acceptable oncological outcomes for recurrent prostate cancer patients. Careful pre-treatment assessment, including advanced imaging, is crucial for selecting suitable candidates for this procedure.

Keywords:
prostate cancerrecurrencesalvage radical prostatectomysystematic review

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Area of Science:

  • Urology
  • Oncology
  • Surgical Oncology

Background:

  • Recurrent prostate cancer after initial treatment poses a significant clinical challenge.
  • Salvage radical prostatectomy (sRP) is a potential treatment option for localized recurrence.
  • Evidence on oncological and functional outcomes of sRP requires systematic evaluation.

Purpose of the Study:

  • To systematically review the current evidence on oncological and functional outcomes of sRP for recurrent prostate cancer.
  • To assess complication rates, survival, and urinary continence after sRP.
  • To identify factors influencing outcomes after sRP.

Main Methods:

  • Systematic review of PubMed, Science Direct, Scopus, and Embase databases up to September 2022.
  • Adherence to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.
  • Inclusion of 55 studies encompassing 3836 patients treated with sRP.

Main Results:

  • Most patients (84%) received prior radiation therapy.
  • Robotic surgery increased post-2019, with overall complication rates at 34% (mostly Clavien I/II).
  • 5-year survival rates ranged from 62-100%, with biochemical recurrence varying significantly; urinary continence was 52.1%.

Conclusions:

  • Salvage radical prostatectomy demonstrates acceptable oncological outcomes in selected patients with recurrent prostate cancer.
  • Pre-treatment assessment, particularly advanced imaging like mpMRI, is vital for patient selection.
  • While sRP is a viable option, the current level of evidence remains low, necessitating further high-quality research.