A retrospective study, using a national database, analyzed data from patients with prostate cancer and found that a complex surgical procedure — salvage radical prostatectomy (SRP) — can greatly improve long-term survival outcomes in those whose cancer has returned despite radiation therapy. The study, “Survival Outcomes in Men Undergoing Radical Prostatectomy after Primary Radiation Treatment for Adenocarcinoma of the Prostate,” was published in the Clinical Genitourinary Cancer journal.
Optimal prostate cancer treatment depends a number of variables, such as cancer stage and expected life span. Radiation therapy has traditionally been a primary treatment option, but about 25 percent of treated patients experience a return of the cancer within five years.
University of Missouri School of Medicine researchers used the Surveillance, Epidemiology, and End Results (SEER) database to identify patients with prostate cancer who underwent surgery after radiation. They analyzed overall and cancer-specific survival outcomes in 364 patients who underwent salvage radical prostatectomy (SRP), a currently underutilized treatment modality, for radio-recurrent prostate cancer. This procedure involves the surgical removal, either using a robotic technique or open surgery, of the prostate gland and surrounding tissue in the attempt to keep the cancer from spreading. But it can be challenging because of tissue scarring during radiation, which might make it harder to identify tissue that must be removed.
Results from the analysis indicated that overall survival among surgery patients was 77.5 percent at 10 years and 37.3 percent at 20 years, while cancer-specific survival was 88.6 percent at 10 years and 72.7 percent at 20 years.
While researchers acknowledged that the small sample size limited the study’s power, its results still indicated that long-term survival can be achieved through SRP. “Because radical prostatectomy is a complex surgery, there can be a reluctance to undergo the procedure. However, this study shows that it is a viable treatment option. This can bring a renewed hope and peace of mind to men living with prostate cancer,” Dr. Naveen Pokala, an assistant professor in the school’s Division of Urology and the study’s lead author, said in a press release.
The American Cancer Society estimates that some 180,890 new cases of prostate cancer, and 26,120 deaths due to the malignancy, will occur in the United States by the end of 2016.