'Salvage' prostate surgery has improved

For men with prostate cancer that recurs after radiation therapy, 'salvage' surgery to remove the prostate can lead to long-term cancer control, New York- based researchers report.

Moreover, the side effects of the procedure are "acceptable," the team reports in the Journal of Urology.

"Salvage radical prostatectomy is technically demanding, but the procedure can be performed safely by an experienced surgeon," Dr. James A. Eastham told AMN Health.

"Although rates of urinary incontinence and Erectile dysfunction are higher than after standard radical prostatectomy, these outcomes continue to improve."

Eastham, of Memorial Sloan-Kettering Cancer Center, and colleagues reviewed data from 100 patients who underwent the procedure between 1984 and 2003 following external beam radiation or radioactive seed implants.

Between 1993 and 2003, the rate of major complications dropped significantly from 33 percent to 13 percent, and the rate of rectal injury fell from 15 percent to 2 percent.

Five years after undergoing the operation, one third of patients were not incontinent, and the majority of the others required one pad daily or less.

Moreover, 23 patients who required three or more pads daily became continent after they were fitted with an artificial urinary sphincter.

As for erectile difficulties after five years, overall, the potency rate was 28 percent following nerve-sparing radical prostatectomy. However, among patients who were previously potent, 45 percent remained so.

Thus, the team concludes that the relatively good outcomes after salvage radical prostatectomy "should persuade more physicians to consider patients for this potentially curative procedure."

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SOURCE: Journal of Urology, December 2004.