PMID- 36601045 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230111 IS - 2666-1683 (Electronic) IS - 2666-1691 (Print) IS - 2666-1683 (Linking) VI - 47 DP - 2023 Jan TI - Topography of Prostate Cancer Recurrence: A Single-centre Analysis of Salvage Radical Prostatectomy Specimens and Implications for Focal Salvage Treatments. PG - 110-118 LID - 10.1016/j.euros.2022.11.017 [doi] AB - BACKGROUND: Most prostate cancer (PCa) recurrences after nonsurgical first-line treatment are managed with androgen deprivation therapy (ADT). When local treatment is indicated, salvage focal treatment (FT) may achieve outcomes similar to those after salvage radical prostatectomy (sRP), with lower morbidity. However, descriptions of the topography of PCa recurrence are scarce. OBJECTIVE: To describe the characteristics and topography of recurrent PCa at sRP. DESIGN SETTING AND PARTICIPANTS: We performed a review of the final pathology for consecutive men undergoing sRP at a single centre between 2007 and 2021. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Clinical and pathological outcomes and recurrence localisation (standardised map) were recorded. Suitability for salvage FT was evaluated using criteria defined a priori. RESULTS AND LIMITATIONS: We included 41 men who underwent sRP after whole-gland treatment (82.9% primary radiotherapy). Of these, 68.3% had grade group >/=3 and 46.3% had pT3 disease, including nine men (22%) with seminal vesicle involvement >1 cm. The pN+ rate was 29.3%. Surgical margins were positive in 39% (mostly at the apex, 21.9%). PCa was located at <3 mm from the apex in 68% of cases. The segment most frequently involved was the mid-gland (93%). The median prostate and index lesion (IL) volume was 31.4 cm(3) (interquartile range [IQR] 23-37) and 2 cm(3) (IQR 0.5-6), respectively. A solitary IL was present in 63.4% of cases, while 7.3% had whole-gland PCa involvement. Overall, 56% of the men (n = 23) were deemed suitable for salvage FT (although seven had pN+ disease). The sample size, single-centre retrospective design, and unavailability of magnetic resonance imaging data are the main limitations. CONCLUSIONS: According to sRP pathology, radiorecurrent PCa is an aggressive disease, frequently showing extraprostatic extension, positive margins, and apical involvement. The majority of cases still harbour a solitary index lesion and a consistent proportion may be suitable for a gland-preserving strategy. PATIENT SUMMARY: In this report we looked at the location of prostate cancer recurrence within the prostate gland after radiotherapy or ablation, in which energy (such as heat, cold, or laser energy) is used to kill cells. We found that although these recurrences are often high-grade locally advanced disease, around half of cases might be suitable for a gland-preserving salvage treatment. CI - (c) 2022 The Authors. FAU - Marra, Giancarlo AU - Marra G AD - Department of Surgical Sciences and Urology Clinic, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - Calleris, Giorgio AU - Calleris G AD - Department of Surgical Sciences and Urology Clinic, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - Massari, Emilia AU - Massari E AD - Department of Surgical Sciences and Urology Clinic, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - Vissio, Elena AU - Vissio E AD - Department of Pathology, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - Molinaro, Luca AU - Molinaro L AD - Department of Pathology, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - Cassoni, Paola AU - Cassoni P AD - Department of Pathology, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - D'Agate, Daniele AU - D'Agate D AD - Department of Surgical Sciences and Urology Clinic, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - Oderda, Marco AU - Oderda M AD - Department of Surgical Sciences and Urology Clinic, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - Valerio, Massimo AU - Valerio M AD - Department of Urology, CHUV, Lausanne, Switzerland. FAU - Raskin, Yannick AU - Raskin Y AD - Department of Urology, Leuven University, Leuven, Belgium. FAU - Joniau, Steven AU - Joniau S AD - Department of Urology, Leuven University, Leuven, Belgium. FAU - Papotti, Mauro AU - Papotti M AD - Department of Pathology, University of Turin and Citta della Salute e della Scienza, Turin, Italy. FAU - Gontero, Paolo AU - Gontero P AD - Department of Surgical Sciences and Urology Clinic, University of Turin and Citta della Salute e della Scienza, Turin, Italy. LA - eng PT - Journal Article DEP - 20221215 PL - Netherlands TA - Eur Urol Open Sci JT - European urology open science JID - 101771568 PMC - PMC9806711 OTO - NOTNLM OT - Focal therapy OT - Recurrent prostate cancer OT - Salvage radical prostatectomy EDAT- 2023/01/06 06:00 MHDA- 2023/01/06 06:01 PMCR- 2022/12/15 CRDT- 2023/01/05 02:21 PHST- 2022/11/23 00:00 [accepted] PHST- 2023/01/05 02:21 [entrez] PHST- 2023/01/06 06:00 [pubmed] PHST- 2023/01/06 06:01 [medline] PHST- 2022/12/15 00:00 [pmc-release] AID - S2666-1683(22)02705-7 [pii] AID - 10.1016/j.euros.2022.11.017 [doi] PST - epublish SO - Eur Urol Open Sci. 2022 Dec 15;47:110-118. doi: 10.1016/j.euros.2022.11.017. eCollection 2023 Jan.