Presentation Authors: Lorenzo Marconi*, Thomas Stonier, London, United Kingdom, Rafael Tourinho-Barbosa, Xavier Cathelineau, Paris, France, Ben Challacombe, Prokar Dasgupta, Rick Popert, London, United Kingdom, Sanchez-Salas Rafael, Paris, France, Declan Murphy, Melbourne, Australia, Paul Cathcart, London, United Kingdom
Introduction: Currently, there is a lack of evidence comparing the outcomes of salvage RP in patients experiencing Prostate Cancer(PCa) recurrence following primary a)whole-gland radiotherapy(RT) or b)focal therapy(FT). Our objective is to compare the functional and oncological outcomes of Salvage Robotic Assisted Radical Prostatectomy (S-RALP) after failure of whole gland RT (EBRT or Brachytherapy) vs. failure of FT.
Methods: Multi-centre, international, cohort study of 164 consecutive patients submitted to S-RALP to treat PCa recurrence after primary treatment. Patients were divided in 2 groups: Group A (after EBRT/Brachytherapy, n=82), and Group B (after FT, n=82). We included patients with histological confirmation of residual/recurrent prostate cancer within the six months previous to radical prostatectomy. In all patients metastatic disease was excluded with a pelvic MRI, bone scan and/or PET-CT. We compared both groups in terms of biochemical Recurrence Free Survival (bRFS) - which was defined on the basis of no biochemical relapse (PSA < 0.2ng/mL) and no need for additional treatment; urinary continence (defined as the use of no pads), potency and perioperative outcomes.
Results: From June 2007 to June 2018, 164 patients were submitted to S-RALP. Table 1 shows Baseline Characteristics and Outcomes. The positive margin rate was higher in patients submitted to S-RALP after RT(36.6% vs 13.4%,p=0.001) however the absolute biochemical recurrence rate and bRFS post S-RALP were similar in both groups. Continence rates were much higher in patients submitted to S-RALP after FT (83.1% vs. 49.3%, p < 0.001). Post-operative potency rates were similar in both groups(GroupB 13.9% vs. GroupA 10.8%, p=0.6). Group A had 2 intraoperative complications (1 rectal injury and 1 ureteric injury). Post-operative complications were much higher in group A (34.1% vs 6.4%, p < 0.001).(Table1)
Conclusions: Robotic prostatectomy following focal ablation therapy is associated with better functional outcome and a lower rate of postoperative complications than men undergoing surgery for recurrent disease following radiation therapy. Oncological outcomes appear similar in both Groups.