MP67-08 SALVAGE ROBOT ASSISTED RADICAL PROSTATECTOMY VS SALVAGE RE-IRRADIATION FOR PATIENT WITH RADIO-RECURRENT PROSTATE CANCER AFTER PRIMARY RADIOTHERAPY: ONCOLOGICAL OUTCOMES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III (MP67)1 Apr 2020MP67-08 SALVAGE ROBOT ASSISTED RADICAL PROSTATECTOMY VS SALVAGE RE-IRRADIATION FOR PATIENT WITH RADIO-RECURRENT PROSTATE CANCER AFTER PRIMARY RADIOTHERAPY: ONCOLOGICAL OUTCOMES Damiano Vizziello*, Ettore Di Trapani, Dario Zerini, Damaris Patricia Rojas, Francesco Alessandro Mistretta, Stefano Luzzago, Giulia Marvaso, Andrea Conti, Giulia Garelli, Giovanni Cordima, Giuseppe Petralia, Matteo Ferro, Victor Deliu Matei, Barbara Alicja Jereczek, Gennaro Musi, and Ottavio de Cobelli Damiano Vizziello*Damiano Vizziello* More articles by this author , Ettore Di TrapaniEttore Di Trapani More articles by this author , Dario ZeriniDario Zerini More articles by this author , Damaris Patricia RojasDamaris Patricia Rojas More articles by this author , Francesco Alessandro MistrettaFrancesco Alessandro Mistretta More articles by this author , Stefano LuzzagoStefano Luzzago More articles by this author , Giulia MarvasoGiulia Marvaso More articles by this author , Andrea ContiAndrea Conti More articles by this author , Giulia GarelliGiulia Garelli More articles by this author , Giovanni CordimaGiovanni Cordima More articles by this author , Giuseppe PetraliaGiuseppe Petralia More articles by this author , Matteo FerroMatteo Ferro More articles by this author , Victor Deliu MateiVictor Deliu Matei More articles by this author , Barbara Alicja JereczekBarbara Alicja Jereczek More articles by this author , Gennaro MusiGennaro Musi More articles by this author , and Ottavio de CobelliOttavio de Cobelli More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000947.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To compare oncological outcomes after salvage Robot Assisted Radical Prostatectomy (S-RARP) or salvage re-irradiation (S-RT) in patients with radiation-recurrent prostate cancer (rrPCa) after primary external beam radiation therapy (EBRT) or brachytherapy (BT). METHODS: We retrospective identified 74 patients with rrPCa (2010-2016). Of those, 54 (73 %) vs. 20 (27 %) were previously treated with EBRT vs. BT. All patients with rrPCa were diagnosed with PSA raising and choline PET (showing non-metastatic disease), or multiparametric MRI followed by prostate biopsy in both groups. Overall, 29 (40%) vs. 45 (60%) patients were treated with S-RARP vs. S-RT. All S-RARP were non Nerve Sparing with extended bilateral pelvic limph node dissection, while S-RT patients underwent intensity modulated or stereotactic radiation therapy on the prostate with a 25 to 30 Gy dose divided in 5 to 6 fractions. Kaplan-Meier plots depicted progression free (PFS), cancer-specific (CSS) and overall (OS) rates over time in S-RARP vs. S-RT patients. The cut off for Biochemical Relapse (BCR) after S-RT was assessed as PSA nadir after RT + 2 ng/ml, according to the Philadelphia criteria, while for S-RARP was 0,1 ng/ml. RESULTS: Compared to S-RARP, patients treated with S-RT were older (75.8 vs. 67 years; p=0.001). Overall, 16 (55%) vs. 23 (52%) and 13 (45%) vs. 22 (48%) patients treated with S-RARP vs. S-RT had a primary diagnosis of ISUP GG1 and ISUP GG 2 PCa before primary RT (p=0.7). Median time from primary RT to salvage treatment was, respectively, 65.5 (IQR 26.55 - 90.15) vs 102.6 (IQR 78.4 – 130.6) months for S-RARP vs S-RT (P= 0.001). Median time follow-up after salvage treatment was 41.5 months. Overall, 11 (39.3%) vs. 22 (56.4%) patients had biochemical recurrence after S-RARP vs. S-RT (p=0.1). Moreover, CSM and OCM rates were, respectively, 0(0 %) vs. 6 (13 %) (p=0,04) and 0 (0 %) vs. 6 (13 %) (p= 0,04) in patients treated with S-RARP vs. S-RT. CONCLUSIONS: S-RARP and S-RT appears to achieve the same rates of cancer control in patient swith radio-recurrent prostate cancer after primary RT. Despite this, randomized control trials are needed to confirm these results. Source of Funding: none. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1028-e1028 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Damiano Vizziello* More articles by this author Ettore Di Trapani More articles by this author Dario Zerini More articles by this author Damaris Patricia Rojas More articles by this author Francesco Alessandro Mistretta More articles by this author Stefano Luzzago More articles by this author Giulia Marvaso More articles by this author Andrea Conti More articles by this author Giulia Garelli More articles by this author Giovanni Cordima More articles by this author Giuseppe Petralia More articles by this author Matteo Ferro More articles by this author Victor Deliu Matei More articles by this author Barbara Alicja Jereczek More articles by this author Gennaro Musi More articles by this author Ottavio de Cobelli More articles by this author Expand All Advertisement PDF downloadLoading ...