Salvage Robot-assisted Radical Prostatectomy Following Focal Ablation with Irreversible Electroporation: Feasibility, Oncological and Functional Outcomes

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2022 Mar 3

PMID 35236338

Authors

Alexandar Blazevski

William Gondoputro

Matthijs J Scheltema

Amer Amin

Bart Geboers

Daniela Barreto

Anne-Maree Haynes

Ron Shnier

Warick Delprado

Shikha Agrawal

James E Thompson

Phillip D Stricker

Affiliations

Soon will be listed here.

Abstract

Background: To report the feasibility, oncological and functional outcomes of salvage robot-assisted radical prostatectomy (sRARP) for recurrent prostate cancer (PCa) after irreversible electroporation (IRE).

Methods: This was a retrospective analysis of patients who underwent sRARP by a single high-volume surgeon after IRE treatment in our institution. Surgical complications, oncological and functional outcomes were assessed.

Results: 15 patients with at least 12 months follow up were identified out of the 234 men who underwent primary IRE between 2013 and 2019. The median [IQR] age was 68 (62-70) years. The median [IQR] time from focal IRE to sRARP was 42 (21-57) months. There were no rectal, bladder or ureteric injuries. The T-stage was pT2 in 9 (60%) patients and pT3a in 6 (40%) patients. Only one (7%) patient had a positive surgical margin. At a median [IQR] follow up of 22 (16-32) months no patient had a biochemical recurrence (PSA > 0.2). All 15 patients were continent (pad-free) by 6 months and 9 (60%) patients had erections sufficient for intercourse with or without PDE5 inhibitors. No predisposing factors were identified for predicting erectile dysfunction after sRARP.

Conclusions: In patients with recurrent or residual significant PCa after focal IRE ablation it is feasible to obtain good functional and oncological outcomes with sRARP. Our results demonstrate that good outcomes can be achieved with sRARP, when respecting close monitoring post-IRE, good patient selection and surgical experience. The limitations of this study are that it is a small series, with short follow up and a lack of standardised quality of life instruments.

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