Abstract
MP25-10 SALVAGE LOCAL TREATMENT FOR RECURRENT PROSTATE CANCER AFTER FOCAL THERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS
The Journal of urology, Vol.211(5S), p.e408
05/2024
DOI: 10.1097/01.JU.0001008692.26556.39.10
Abstract
INTRODUCTION AND OBJECTIVE:
Focal therapy (FT) for localized prostate cancer (PCa) shows acceptable oncological control and low toxicity; however, a proportion of men will still develop recurrent disease and will need additional treatment. We evaluated the role of salvage local treatment modalities regarding oncological (biochemical recurrence rate post-salvage treatment)and functional outcomes (urinary incontinence and erectile dysfunction).
METHODS:
A systematic review and meta-analysis were performed. We searched PubMed and EMBASE until May/2023.Eligible studies included patients with clinically localized PCa initially treated with FT that relapsed on surveillance and were subsequently treated with salvage radical prostatectomy (sRP), salvage external beam radiation therapy (sEBRT) or salvage focal therapy (sFT).
RESULTS:
Twenty-six retrospective studies comprising 990 patients were included. The overall pooled rate of biochemical recurrence after salvage treatment was 26% (95%CI 23-30%; I2=71%). Subgroup analysis showed a biochemical recurrence rate of 20% for sRP (95%CI 16-25%; I2=53%), 22% for sEBRT (95%CI 18-26%; I2=54%) and 42% after sFT (95%CI 35-50%; I2=20%). The overall pooled rate of urinary incontinence was 20% (95%CI 18-24%; I2=68%). Salvage FT had the lowest prevalence (8%, 95%CI 5-14%; I2=60%), followed by sRP (20%, 95%CI 16-25%; I2=57%) and sEBRT (25%, 95%CI 20-30%; I2=65%). The overall pooled rate of erectile dysfunction was 43% (95%CI 38-48%; I2=92%). Salvage RP had the highest prevalence (61%, 95%CI 54-68%; I2=89%), followed by sFT (29%, 95%CI 22-36%; I2=92%) and sEBRT (26%, 95%CI 18-35%; I2=75%). There was substantial heterogeneity among studies, especially due to different sample sizes. Meta regression analysis considering salvage treatment modalities, extent of the ablation, age, PSA before salvage, proportion of Gleason >7 at recurrence, and time between the primary and salvage therapies showed none or low contribution for heterogeneity.
CONCLUSIONS:
Salvage local treatments for recurrent PCa after FT are feasible and showed acceptable oncological and functional outcomes. sRP and sEBRT appear to have the lowest biochemical recurrence rate, while sFT is associated with improved functional outcomes.
Details
- Title: Subtitle
- MP25-10 SALVAGE LOCAL TREATMENT FOR RECURRENT PROSTATE CANCER AFTER FOCAL THERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS
- Creators
- Lucas S. TakemuraPedro H. P. CostaOliver R. ClarosRafael R. Tourinho-BarbosaSaulo B. TelesPaulo P. KayanoRafael Sanchez-SalasBruno NaharHelen Y. HougenAbhishek BhatRuben OlivaresBianca A. V. BiancoGustavo C. LemosArie Carneiro
- Resource Type
- Abstract
- Publication Details
- The Journal of urology, Vol.211(5S), p.e408
- DOI
- 10.1097/01.JU.0001008692.26556.39.10
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 05/2024
- Academic Unit
- Urology
- Record Identifier
- 9984701837002771
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