alexa Population-based analysis of salvage radical prostatectomy with examination of factors associated with adverse perioperative outcomes.
Oncology

Oncology

Journal of Nuclear Medicine & Radiation Therapy

Author(s): Pearce SM, Richards KA, Patel SG, Pariser JJ, Eggener SE

Abstract Share this page

Abstract INTRODUCTION: Salvage radical prostatectomy (SRP) is a potentially curative operation performed for recurrent prostate cancer after radiation therapy (RT). The purpose of this study was to examine perioperative and pathologic outcomes of SRP in a national cohort. MATERIALS AND METHODS: The National Cancer Database from 1998 to 2011 was used to identify 408 patients who underwent SRP. We evaluated the demographic data, clinical variables, and pathologic and perioperative outcomes. Primary outcomes of interest were length of stay (LOS) and positive surgical margins (PSM). A multivariable logistic regression model was employed to identify preoperative predictors of LOS ≥ 3 days and PSM following SRP. RESULTS: Among patients undergoing SRP, the mean age was 62.5 ± 6.8 years, mean prostate-specific antigen (PSA) level was 12.6 ± 15.6 ng/ml, and 64\% were categorized as clinical stage T1. External beam RT (89\%), followed by brachytherapy (11\%), was the most common modalities for primary RT. Most SRPs were performed at high-volume centers (57\%) in metropolitan locations (83\%). Most patients underwent a lymph node dissection (75\%) and the mean node count was 15.0 ± 30.1. On final pathology, 73\% had intermediate- or high-grade disease (Gleason score 7 in 43\% and Gleason score 8-10 in 30\%), 49\% had pT3 or pT4 disease, 6.2\% had positive lymph nodes, and 34\% had PSM. The mean LOS was 3.5 ± 9.9 days, and 43\% of patients had a LOS ≥ 3 days. The 30-day readmission rate was 6.5\% after SRP, and 30- and 90-day postoperative mortality rates were extremely low at 0.4\% (n = 1). On multivariable analysis of the entire cohort, PSA level > 20 ng/ml was an independent predictor of PSM (OR = 3.68, 95\% CI: 1.2-10.9, P = 0.018). PSA level > 20 ng/ml (OR = 4.37, 95\% CI: 1.2-16.2, P = 0.027) and cT2 or greater disease (OR = 2.52, 95\% CI: 1.0-6.2, P = 0.046) were associated with prolonged LOS (LOS ≥ 3d), whereas surgery at an academic facility (OR = 0.30, 95\% CI: 0.1-0.8, P = 0.02) reduced the odds of LOS ≥ 3 days. CONCLUSIONS: In select patients derived from a population-based cohort, SRP results in effective local cancer control with acceptable perioperative outcomes. PSA level > 20 ng/ml is independently associated with PSM and prolonged LOS after SRP. Clinical stage T2 or greater disease is also associated with prolonged LOS, whereas surgery at an academic facility reduced this risk. Copyright © 2015 Elsevier Inc. All rights reserved. This article was published in Urol Oncol and referenced in Journal of Nuclear Medicine & Radiation Therapy

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

agrifoodaquavet@omicsonline.com

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

clinical_biochem@omicsonline.com

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

business@omicsonline.com

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

chemicaleng_chemistry@omicsonline.com

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

environmentalsci@omicsonline.com

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

engineering@omicsonline.com

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

generalsci_healthcare@omicsonline.com

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

genetics_molbio@omicsonline.com

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

immuno_microbio@omicsonline.com

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

omics@omicsonline.com

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

materialsci@omicsonline.com

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

mathematics_physics@omicsonline.com

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

medical@omicsonline.com

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neuro_psychology@omicsonline.com

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

pharma@omicsonline.com

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

social_politicalsci@omicsonline.com

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version