Salvage radical prostatectomy for XXXX : a multi-institutional collaboration.

@entity1 @entity263 @entity5 @entity3 @entity204
BACKGROUND: Oncologic outcomes in @entity1 with @entity263 (PCa) treated with salvage radical prostatectomy (SRP) are poorly defined. OBJECTIVE: To identify predictors of biochemical recurrence (BCR), @entity3 , and @entity204 following SRP to help select @entity1 who may benefit from SRP. DESIGN, SETTING, AND @entity1 : This is a retrospective, international, multi-institutional cohort analysis. There was a median follow-up of 4.4 yr following SRP performed on 404 @entity1 with radiation-recurrent PCa from 1985 to 2009 in tertiary centers. INTERVENTION: Open SRP. MEASUREMENTS: BCR after SRP was defined as a serum prostate-specific antigen (PSA) >=  0.1 or >=  0.2 ng/ml (depending on the institution). Secondary end points included progression to @entity3 and @entity5 . RESULTS AND LIMITATIONS: Median age at SRP was 65 yr of age, and median pre-SRP PSA was 4.5 ng/ml. Following SRP, 195 @entity1 experienced BCR, 64 developed @entity3 , and 40 died from PCa. At 10 yr after SRP, BCR-free survival, @entity3 -free survival, and @entity5 -specific survival (CSS) probabilities were 37% (95% confidence interval [CI], 31-43), 77% (95% CI, 71-82), and 83% (95% CI, 76-88), respectively. On preoperative multivariable analysis, pre-SRP PSA and Gleason score at postradiation prostate biopsy predicted BCR (p = 0.022; global p < 0.001) and @entity3 (p = 0.022; global p < 0.001). On postoperative multivariable analysis, pre-SRP PSA and pathologic Gleason score at SRP predicted BCR (p = 0.014; global p < 0.001) and @entity3 (p < 0.001; global p < 0.001). Lymph node involvement (LNI) also predicted @entity3 (p = 0.017). The main limitations of this study are its retrospective design and the follow-up period. CONCLUSIONS: In a select group of @entity1 who underwent SRP for radiation-recurrent PCa, freedom from clinical @entity3 was observed in >75% of @entity1 10 yr after surgery. @entity1 with lower pre-SRP PSA levels and lower postradiation prostate biopsy Gleason score have the highest probability of cure from SRP.
