BACKGROUND AND OBJECTIVE: Persistent prostatic specific antigen (PSA) represents a poor prognostic factor for recurrence after radical prostatectomy (RP). However, the impact of persistent PSA on oncologic outcomes in patients undergoing salvage RP is unknown. To investigate the impact of persistent PSA after salvage RP on long-term oncologic outcomes. MATERIAL AND METHODS: Patients who underwent salvage RP for recurrent prostate cancer between 2000 and 2021 were identified from twelve high-volume centers. Only patients with available PSA after salvage RP were included. Kaplan-Meier analyses and multivariable Cox regression models were used to test the effect of persistent PSA on biochemical recurrence (BCR), metastasis and any death after salvage RP. Persistent PSA was defined as a PSA-value ≥ 0.1 ng/ml, at first PSA-measurement after salvage RP. RESULTS: Overall, 580 patients were identified. Of those, 42% (n = 242) harbored persistent PSA. Median follow-up after salvage RP was 38 months, median time to salvage RP was 64 months and median time to first PSA after salvage RP was 2.2 months. At 84 months after salvage RP, BCR-free, metastasis-free, and overall survival was 6.6 vs. 59%, 71 vs. 88% and 77 vs. 94% for patients with persistent vs. undetectable PSA after salvage RP (all p < 0.01). In multivariable Cox models persistent PSA was an independent predictor for BCR (HR: 5.47, p < 0.001) and death (HR: 3.07, p < 0.01). CONCLUSION: Persistent PSA is common after salvage RP and represents an independent predictor for worse oncologic outcomes. Patients undergoing salvage RP should be closely monitored after surgery to identify those with persistent PSA.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru * patologie   chirurgie   krev   MeSH
• nádorové biomarkery krev   MeSH
• nádory prostaty * chirurgie   patologie   krev   mortalita   MeSH
• následné studie MeSH
• prognóza MeSH
• prostatektomie * metody   MeSH
• prostatický specifický antigen * krev   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• záchranná terapie * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: Lymph node invasion (LNI) represents a poor prognostic factor after primary radical prostatectomy (RP) for prostate cancer (PCa). However, the impact of LNI on oncologic outcomes in salvage radical prostatectomy (SRP) patients is unknown. OBJECTIVE: To investigate the impact of lymph node dissection (LND) and pathological lymph node status (pNX vs. pN0 vs. pN1) on long-term oncologic outcomes of SRP patients. PATIENTS AND METHODS: Patients who underwent SRP for recurrent PCa between 2000 and 2021 were identified from 12 high-volume centers. Kaplan-Meier analyses and multivariable Cox regression models were used. Endpoints were biochemical recurrence (BCR), overall survival (OS), and cancer-specific survival (CSS). RESULTS: Of 853 SRP patients, 87% (n = 727) underwent LND, and 21% (n = 151) harbored LNI. The median follow-up was 27 months. The mean number of removed lymph nodes was 13 in the LND cohort. At 72 months after SRP, BCR-free survival was 54% vs. 47% vs. 7.2% for patients with pNX vs. pN0 vs. pN1 (p < 0.001), respectively. At 120 months after SRP, OS rates were 89% vs. 81% vs. 41% (p < 0.001), and CSS rates were 94% vs. 96% vs. 82% (p = 0.02) for patients with pNX vs. pN0 vs. pN1, respectively. In multivariable Cox regression analyses, pN1 status was independently associated with BCR (HR: 1.77, p < 0.001) and death (HR: 2.89, p < 0.001). CONCLUSIONS: In SRP patients, LNI represents an independent poor prognostic factor. However, the oncologic benefit of LND in SRP remains debatable. These findings underline the need for a cautious LND indication in SRP patients as well as strict postoperative monitoring of SRP patients with LNI.

• Publikační typ
• časopisecké články MeSH

Depend on Hinman’s for up-to-date, authoritative guidance covering the entire scope of urologic surgery. Regarded as the most authoritative surgical atlas in the field, Hinman's Atlas of Urologic Surgery, 4th Edition, by Drs. Joseph A. Smith, Jr., Stuart S. Howards, Glenn M. Preminger, and Roger R. Dmochowski, provides highly illustrated, step-by-step guidance on minimally invasive and open surgical procedures, new surgical systems and equipment, and laparoscopic and robotic techniques. New chapters keep you up to date, and all-new commentaries provide additional insight from expert surgeons

• MeSH
• urogenitální chirurgické výkony MeSH
• urogenitální systém * chirurgie   MeSH
• Publikační typ
• atlasy MeSH

• Konspekt
• Ortopedie. Chirurgie. Oftalmologie
• NLK Obory
• chirurgie
• urologie

• MeSH
• urogenitální chirurgické výkony MeSH
• urogenitální systém chirurgie   MeSH
• Publikační typ
• atlasy MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• urologie

• MeSH
• erektilní dysfunkce chirurgie   prevence a kontrola   MeSH
• inkontinence moči chirurgie   prevence a kontrola   MeSH
• laparoskopie metody   využití   MeSH
• lidé MeSH
• nádory prostaty chirurgie   MeSH
• prostatektomie metody   MeSH
• robotika využití   MeSH
• urologické chirurgické výkony u mužů metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH

• MeSH
• nádory prostaty chirurgie   MeSH
• nemoci prostaty chirurgie   MeSH
• prostatektomie metody   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• nefrologie
• urologie

• MeSH
• laserová terapie MeSH
• urologické chirurgické výkony metody   MeSH
• urologické nemoci chirurgie   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• nefrologie
• urologie

• MeSH
• nádory prostaty terapie   MeSH
• urologické chirurgické výkony u mužů MeSH
• varikokéla chirurgie   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• nefrologie
• urologie

• Klíčová slova
• prostata - rakovina - systémy terapeutické - monografie,
• MeSH
• nádory prostaty terapie   MeSH
• prostata MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• nefrologie
• onkologie
• chirurgie
• endokrinologie
• urologie

• MeSH
• laserová terapie MeSH
• urologické chirurgické výkony metody   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• nefrologie
• urologie