Prostate surgery often works after radiation fails

"Salvage" surgery should be considered for men who have persistent Prostate cancer despite undergoing radiation therapy, US researchers contend.

In their 30-year experience, "significant" survival can be expected following surgery, say Dr. John F. Ward from the Naval Medical Center in Portsmouth, Virginia, and colleagues in a report in The Journal of Urology.

They describe outcomes with surgery for 199 patients with biopsy-proven Prostate cancer following radiotherapy, who then underwent removal of the prostate.

Overall 10-year survival for all patients was 65 percent, they report. On average, the men survived for 12 years following surgery.

The aggressiveness and stage of the excised tumor were significant predictors of survival, whereas the pre-operative PSA level had "little prognostic value" and, in some cases, "may be counterintuitive," the team found.

The data also show that complications, including Urinary Incontinence, "moderately improved with time."

Salvage surgery following initial treatment of localized prostate cancer with radiotherapy is "a feasible and viable option for a growing number of young healthy men," Ward and colleagues conclude.

Men with life expectancy of 10 years or more and localized tumors are most likely to benefit from salvage surgery, they suggest.

SOURCE: Journal of Urology, April 2005.