Salvage Radical Prostatectomy After Primary Treatment Failure of Clinically Localized Prostate Cancer: A Single Surgeon Case Series

Salvage Radical Prostatectomy After Primary Treatment Failure of Clinically Localized Prostate Cancer: A Single Surgeon Case Series
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Title:Salvage Radical Prostatectomy After Primary Treatment Failure of Clinically Localized Prostate Cancer: A Single Surgeon Case Series
Author/Abstract:
Luzcielo M. Roxas, MD and Jason L. Letran, MD, DPBU

Section of Urology, Department of Surgery, Cardinal Santos Medical Center 

Salvage radical prostatectomy after failure of primary radiation or cryosurgical ablation for localized prostate cancer can still offer potential cure for patients. However, it is fraught with more difficulty in the dissection of irradiated and cryoablated tissue. Likewise, it is potentially associated with more peri-operative and postoperative complications. Thus, it is a less than attractive option, both for the patients and the urologists as well. In the Philippine setting or even in Asia, there is yet any report on the performance of salvage radical prostatectomy in the setting of radiation and cryosurgical ablation failure. In this article, we report our initial experience with three patients who underwent salvage radical prostatectomy after cryotherapy, external beam using intense modulation radiation treatment (IMRT) and permanent seed brachytherapy, respectively. All of these treatment failures were suspected by virtue of rising serum prostate specific antigen (PSA) and confirmed by needle biopsy of the prostate. Preoperative, intraoperative and postoperative parameters were described and learning points were shared.

Key words: salvage radical prostatectomy, cryotherapy, brachytherapy, intense modulation radiation therapy
 
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