Salvage Radical Prostatectomy for Recurrent Prostate Cancer Following First-line Nonsurgical Treatment: Validation of the European Association of Urology Criteria in a Large, Multicenter, Contemporary Cohort
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Salvage Radical Prostatectomy for Recurrent Prostate Cancer Following First-line Nonsurgical Treatment: Validation of the European Association of Urology Criteria in a Large, Multicenter, Contemporary Cohort. / Calleris, Giorgio; Marra, Giancarlo; Benfant, Nicole; Rajwa, Pawel; Ahmed, Mohamed; Abreu, Andre; Cacciamani, Giovanni; Ghoreifi, Alireza; Ribeiro, Luis; Westhofen, Thilo; Tourinho-Barbosa, Rafael; Raskin, Yannic; Veerman, Hans; Albisinni, Simone; Smith, Joseph A; Rouprêt, Morgan; Oderda, Marco; Massari, Emilia; Persad, Raj; Van Der Poel, Henk; Joniau, Steven; Sanchez-Salas, Rafael; Kretschmer, Alexander; Cathcart, Paul; Gill, Inderbir; Karnes, R Jeffrey; Tilki, Derya; Shariat, Shahrokh F; Touijer, Karim; Gontero, Paolo.
in: EUR UROL FOCUS, Jahrgang 9, Nr. 4, 07.2023, S. 645-649.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › Kurzpublikation › Forschung › Begutachtung
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TY - JOUR
T1 - Salvage Radical Prostatectomy for Recurrent Prostate Cancer Following First-line Nonsurgical Treatment: Validation of the European Association of Urology Criteria in a Large, Multicenter, Contemporary Cohort
AU - Calleris, Giorgio
AU - Marra, Giancarlo
AU - Benfant, Nicole
AU - Rajwa, Pawel
AU - Ahmed, Mohamed
AU - Abreu, Andre
AU - Cacciamani, Giovanni
AU - Ghoreifi, Alireza
AU - Ribeiro, Luis
AU - Westhofen, Thilo
AU - Tourinho-Barbosa, Rafael
AU - Raskin, Yannic
AU - Veerman, Hans
AU - Albisinni, Simone
AU - Smith, Joseph A
AU - Rouprêt, Morgan
AU - Oderda, Marco
AU - Massari, Emilia
AU - Persad, Raj
AU - Van Der Poel, Henk
AU - Joniau, Steven
AU - Sanchez-Salas, Rafael
AU - Kretschmer, Alexander
AU - Cathcart, Paul
AU - Gill, Inderbir
AU - Karnes, R Jeffrey
AU - Tilki, Derya
AU - Shariat, Shahrokh F
AU - Touijer, Karim
AU - Gontero, Paolo
N1 - Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.
PY - 2023/7
Y1 - 2023/7
N2 - Salvage radical prostatectomy (sRP) is a potentially curative option for locally radiorecurrent prostate cancer (PCa) but is associated with significant morbidity. Therefore, the European Association of Urology (EAU) guidelines recommend restricting sRP to a favorable-prognosis group according to the EAU criteria, but these have been validated considering only biochemical recurrence (BCR). Our aim was to test these criteria in a large, multicenter, contemporary cohort. We retrospectively reviewed 1265 patients who underwent sRP at 14 referral centers (2000-2021), stratified by compliance with the EAU criteria. Our primary outcome was metastasis-free survival (MFS). We included 1030 men, of whom 221 (21.5%) fully met the EAU recommended criteria for sRP and 809 (78.5%) did not. The EAU-compliant group experienced more favorable pathological and functional outcomes (79% vs 63% wearing no pads at 1 yr; p < 0.001) and had significantly better MFS (90% vs 76% at 5 yr; p < 0.001), prostate-specific antigen-free survival (55% vs 38% at 5 yr; p < 0.001), and overall survival (89% vs 84% at 5 yr; p = 0.01). This was verified by Cox regression analysis for MFS (hazard ratio 1.84, 95% confidence interval 1.13-2.99; p = 0.01). We found that adherence to the EAU criteria is associated with a lower risk of BCR and, more importantly, of metastasis after surgery. PATIENT SUMMARY: We looked at outcomes of surgical removal of the prostate for prostate cancer recurrence after radiotherapy or other nonsurgical treatments according to whether or not patients met the European Association of Urology (EAU) criteria for this surgery. We found that men who did not meet the criteria had a higher risk of metastasis and their benefit from surgery might be significantly less than for patients who do meet the EUA criteria.
AB - Salvage radical prostatectomy (sRP) is a potentially curative option for locally radiorecurrent prostate cancer (PCa) but is associated with significant morbidity. Therefore, the European Association of Urology (EAU) guidelines recommend restricting sRP to a favorable-prognosis group according to the EAU criteria, but these have been validated considering only biochemical recurrence (BCR). Our aim was to test these criteria in a large, multicenter, contemporary cohort. We retrospectively reviewed 1265 patients who underwent sRP at 14 referral centers (2000-2021), stratified by compliance with the EAU criteria. Our primary outcome was metastasis-free survival (MFS). We included 1030 men, of whom 221 (21.5%) fully met the EAU recommended criteria for sRP and 809 (78.5%) did not. The EAU-compliant group experienced more favorable pathological and functional outcomes (79% vs 63% wearing no pads at 1 yr; p < 0.001) and had significantly better MFS (90% vs 76% at 5 yr; p < 0.001), prostate-specific antigen-free survival (55% vs 38% at 5 yr; p < 0.001), and overall survival (89% vs 84% at 5 yr; p = 0.01). This was verified by Cox regression analysis for MFS (hazard ratio 1.84, 95% confidence interval 1.13-2.99; p = 0.01). We found that adherence to the EAU criteria is associated with a lower risk of BCR and, more importantly, of metastasis after surgery. PATIENT SUMMARY: We looked at outcomes of surgical removal of the prostate for prostate cancer recurrence after radiotherapy or other nonsurgical treatments according to whether or not patients met the European Association of Urology (EAU) criteria for this surgery. We found that men who did not meet the criteria had a higher risk of metastasis and their benefit from surgery might be significantly less than for patients who do meet the EUA criteria.
U2 - 10.1016/j.euf.2023.01.006
DO - 10.1016/j.euf.2023.01.006
M3 - Short publication
C2 - 36682962
VL - 9
SP - 645
EP - 649
JO - EUR UROL FOCUS
JF - EUR UROL FOCUS
SN - 2405-4569
IS - 4
ER -
