MP55-14 SALVAGE ROBOTIC RADICAL PROSTATECTOMY AFTER FOCAL THERAPY VERSUS RADIATION: A 10-YEAR EXPERIENCE

Abstract

You have accessJournal of UrologyCME1 May 2022MP55-14 SALVAGE ROBOTIC RADICAL PROSTATECTOMY AFTER FOCAL THERAPY VERSUS RADIATION: A 10-YEAR EXPERIENCE Alireza Ghoreifi, Masatomo Kaneko, Hooman Djaladat, Andrew Hung, Rene Sotelo, Andre Berger, Mihir Desai, Inderbir Gill, Monish Aron, and Andre Luis Abreu Alireza GhoreifiAlireza Ghoreifi More articles by this author , Masatomo KanekoMasatomo Kaneko More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , Andrew HungAndrew Hung More articles by this author , Rene SoteloRene Sotelo More articles by this author , Andre BergerAndre Berger More articles by this author , Mihir DesaiMihir Desai More articles by this author , Inderbir GillInderbir Gill More articles by this author , Monish AronMonish Aron More articles by this author , and Andre Luis AbreuAndre Luis Abreu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002634.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Salvage robotic radical prostatectomy (sRRP) has gained acceptance in the management of patients with recurrent prostate cancer. Limited data is available regarding the outcomes of this procedure, especially in the setting of primary focal therapy (FT). The aim of this study is to evaluate the outcomes of sRRP after primary FT versus radiation therapy (RT). METHODS: Using our IRB-approved prostate cancer database, we reviewed the records of patients who underwent sRRP following primary local therapy for prostate cancer between Jan 2010 to July 2021. Patients with concomitant procedures, including fistula repair and urethroplasty were excluded. Perioperative findings and long-term outcomes were recorded and compared between FT and RT groups. RESULTS: A total of 100 patients with a median (IQR) age of 68 (63-74) years were included in the final analysis. Of these, 75 received RT (brachy=24, external beam=48, both=3) and 25 FT (Cryo=15, HIFU=8, both=1, focal laser ablation=1) as primary treatment. Median (IQR) time between primary treatment and sRRP was 66 (37-108) months (RT = 82 vs FT = 38M, p=0.0002). The median pre-sRRP PSA in RT vs. FT was 7.6 and 4.95 ng/mL, respectively (p=0.04). Pre-sRRP biopsy showed significantly higher rate of high-grade (GG ≥4) cancer in RT compared to FT (33% vs. 20%, p=0.02). Perioperative and pathology findings are reported in the Table. There was 1 rectal injury in the RT group. 90-day complications were significantly higher in RT vs. FT patients (32% vs. 8%, p=0.02). 6-month, but not 12-month continence (defined as no pad usage) was higher in FT compared to RT (53% vs. 21%, p=0.02 and 67% vs. 35%, p=0.13). A total of 24 patients underwent artificial urethral sphincter (AUS) placement, all of whom were in the RT group. In a median (IQR) follow-up of 24 (5-52) months (RT = 24M vs. FT = 9M; p=0.30), 14 patients developed biochemical recurrence (PSA >0.2 ng/mL), as follows: RT=15% vs. FT=12.5%. On multivariable analysis, history of RT was associated with higher rate of 90-day complications (Odds Ratio=4.9, 95% CI 1.06-23.02, p=0.04). CONCLUSIONS: Salvage robotic radical prostatectomy in patients with recurrent prostate cancer following focal therapy is safe. It is associated with lower 90-day complications and earlier urinary continence compared to the patients who received primary radiotherapy. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e943 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alireza Ghoreifi More articles by this author Masatomo Kaneko More articles by this author Hooman Djaladat More articles by this author Andrew Hung More articles by this author Rene Sotelo More articles by this author Andre Berger More articles by this author Mihir Desai More articles by this author Inderbir Gill More articles by this author Monish Aron More articles by this author Andre Luis Abreu More articles by this author Expand All Advertisement PDF DownloadLoading ...