Mp25-03 Salvage Radical Prostatectomy After Focal Therapy for Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-03 SALVAGE RADICAL PROSTATECTOMY AFTER FOCAL THERAPY FOR PROSTATE CANCER Umar Ghaffar, Giuseppe Reitano, Vidit Sharma, Spyridon P. Basourakos, Grant M. Henning, and Robert J. Karnes Umar GhaffarUmar Ghaffar , Giuseppe ReitanoGiuseppe Reitano , Vidit SharmaVidit Sharma , Spyridon P. BasourakosSpyridon P. Basourakos , Grant M. HenningGrant M. Henning , and Robert J. KarnesRobert J. Karnes View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal therapy (FT) is a popular alternative to radical approaches for selective patients with localized prostate cancer (PCa). FT carries low risk of sexual and urinary toxicities but high risk of recurrence requiring salvage treatments. The outcomes of salvage radical prostatectomy (SRP) following FT are sparsely reported in the existing literature. We report oncological and functional outcomes of this cohort at our institution. METHODS: A retrospective review of all SRP performed at our institute till December 2021 was conducted to identify patients who initially underwent FT for PCa before SRP. Surgical, oncological , and functional outcomes were described. Logistic regression was used to assess factors predicting composite outcome biochemical persistence or recurrence within 1 year. RESULTS: We identified 30 patients who underwent SRP post-FT (16 cryoablation, 12 High Intensity Focused Ultrasound (HIFU), 1 laser ablation and 1 thermal ablation). 2 patients underwent repeat FT before SRP. Types of SRP included 63.3% open and 36.7% laparoscopic. 2 patients had failure of SRP due to severe adhesions. 43.3% patients developed periprocedural complications. On follow-up 25% (7/28) had biochemical persistence (BCP), 28.6% (8/28) developed biochemical recurrence (BCR), 42.9% (12/28) were BCR-free while 1 was lost to follow-up. (Table 1) Of 25 patients who were continent prior to SRP, 72% were pad-free or on security pad only at 1 year. Of 18 patients who were not impotent prior to SRP, 44.4% had no erections while 50% had erections with or without therapy. Only positive surgical margins (PSM) were significant predictors of biochemical persistence or recurrence within 1 year (OR 30.0; 95% CI 2.9 to 315.6; p=0.005). CONCLUSIONS: SRP is feasible for patients with recurrence or failure after FT with good continence and adequate potency outcomes. SRP after FT has high risk of complications, BCP and BCR. PSM are predictive of biochemical failure or recurrence within 1 year of SRP. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e404 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Umar Ghaffar More articles by this author Giuseppe Reitano More articles by this author Vidit Sharma More articles by this author Spyridon P. Basourakos More articles by this author Grant M. Henning More articles by this author Robert J. Karnes More articles by this author Expand All Advertisement PDF downloadLoading ...