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Management of recurrent prostate cancer after radiotherapy: long-term results from CALGB 9687 (Alliance), a prospective multi-institutional salvage prostatectomy series.

Publication ,  Journal Article
Mohler, JL; Halabi, S; Ryan, ST; Al-Daghmin, A; Sokoloff, MH; Steinberg, GD; Sanford, BL; Eastham, JA; Walther, PJ; Morris, MJ; Small, EJ
Published in: Prostate Cancer Prostatic Dis
May 2019

BACKGROUND: To evaluate efficacy and morbidity prospectively in a contemporary multi-institutional salvage radical prostatectomy (SRP) series. METHODS: Forty-one men were enrolled between 1997 and 2006, who suffered biopsy-proven recurrent prostate cancer (CaP) after receiving ≥ 60c Gy radiation as primary treatment for cT1-2NXM0 disease. Surgical morbidity, quality of life, biochemical progression-free survival (BPFS) and overall survival (OS) were evaluated. RESULTS: Twenty-four men had undergone external beam radiotherapy, 11 brachytherapy, and six both. Median time between radiation and SRP was 64 months. Median age at SRP was 64 years. Pathologic staging revealed 44% pT2, 54% pT3, and 3% pT4. Surgical margins were positive in 17 and 88% were pN0. Twenty-two percent required intraoperative blood transfusion. Three rectal and one obturator nerve injuries occurred. Seventeen of 38 evaluable patients (45%) had urinary incontinence ( ≥ 3 pads/day) prior to SRP; 88% reported urinary incontinence at 6 months, 85% at 12 months, 63% at 24 months after SRP. Furthermore, 37% of men reported impotence prior to SRP; 78% reported impotence at 6 months, 82% at 12 months, and 44% at 24 months after SRP. The 2-, 5- and 10-year BPFS rates were 51, 39, and 33% respectively; the 2-, 5- and 10-year OS rates were 100, 89, and 52%, respectively, at median follow-up 91 months. CONCLUSIONS: Modern surgical techniques continue to be associated with significant peri-operative complication rates. Nevertheless, SRP may benefit carefully selected patients through durable oncologic control.

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Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

May 2019

Volume

22

Issue

2

Start / End Page

309 / 316

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Salvage Therapy
  • Retreatment
  • Radiotherapy
  • Prostatic Neoplasms
  • Prostatectomy
  • Prognosis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Neoplasm Grading
 

Citation

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Mohler, J. L., Halabi, S., Ryan, S. T., Al-Daghmin, A., Sokoloff, M. H., Steinberg, G. D., … Small, E. J. (2019). Management of recurrent prostate cancer after radiotherapy: long-term results from CALGB 9687 (Alliance), a prospective multi-institutional salvage prostatectomy series. Prostate Cancer Prostatic Dis, 22(2), 309–316. https://doi.org/10.1038/s41391-018-0106-1
Mohler, James L., Susan Halabi, Stephen T. Ryan, Ali Al-Daghmin, Mitchell H. Sokoloff, Gary D. Steinberg, Ben L. Sanford, et al. “Management of recurrent prostate cancer after radiotherapy: long-term results from CALGB 9687 (Alliance), a prospective multi-institutional salvage prostatectomy series.Prostate Cancer Prostatic Dis 22, no. 2 (May 2019): 309–16. https://doi.org/10.1038/s41391-018-0106-1.
Mohler JL, Halabi S, Ryan ST, Al-Daghmin A, Sokoloff MH, Steinberg GD, et al. Management of recurrent prostate cancer after radiotherapy: long-term results from CALGB 9687 (Alliance), a prospective multi-institutional salvage prostatectomy series. Prostate Cancer Prostatic Dis. 2019 May;22(2):309–16.
Mohler, James L., et al. “Management of recurrent prostate cancer after radiotherapy: long-term results from CALGB 9687 (Alliance), a prospective multi-institutional salvage prostatectomy series.Prostate Cancer Prostatic Dis, vol. 22, no. 2, May 2019, pp. 309–16. Pubmed, doi:10.1038/s41391-018-0106-1.
Mohler JL, Halabi S, Ryan ST, Al-Daghmin A, Sokoloff MH, Steinberg GD, Sanford BL, Eastham JA, Walther PJ, Morris MJ, Small EJ. Management of recurrent prostate cancer after radiotherapy: long-term results from CALGB 9687 (Alliance), a prospective multi-institutional salvage prostatectomy series. Prostate Cancer Prostatic Dis. 2019 May;22(2):309–316.

Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

May 2019

Volume

22

Issue

2

Start / End Page

309 / 316

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Salvage Therapy
  • Retreatment
  • Radiotherapy
  • Prostatic Neoplasms
  • Prostatectomy
  • Prognosis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Neoplasm Grading