Radical Prostatectomy after Vascular Targeted Photodynamic Therapy with Padeliporfin: Feasibility, and Early and Intermediate Results.

Autor:	Pierrard V; Department of Urology, Lyon Sud University Hospital, Lyon., Lebdai S; Departments of Urology, Angers University Hospital, Angers., Kleinclauss F; Hospital Center, Besançon., Azzouzi AR; Departments of Urology, Angers University Hospital, Angers., Terrier JE; Department of Urology, Lyon Sud University Hospital, Lyon., Fortier E; Departments of Urology, Angers University Hospital, Angers., Joniau S; Hospital Center, Leuven, Belgium., Van Der Poel H; Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Salomon G; Spire Portsmouth Hospital, Hamburg, Germany., Casanova J; Hospital Center, Valencia, Spain., Medina-Lopez RA; Virgen del Rocío University Hospital, Sevilla, Spain., Potiron E; Atlantis Clinic, Nantes., Rigaud J; Nantes University Hospital, Nantes., Vincendeau S; Rennes University Hospital, Rennes., Rassweiler J; SLK Kliniken, Heilbronn, Germany., Villers A; Lille University Hospital, Lille., Gaston R; Saint Augustin Clinic, Bordeaux., Saussine C; Strasbourg University Hospital, Strasbourg., Giai J; Department of Biostatistics, Lyon Sud University Hospital, Lyon., Gaillac B; STEBA France, Paris, France., Emberton M; Division of Surgery and Interventional Science, University College London, London, United Kingdom., Ruffion A; Department of Urology, Lyon Sud University Hospital, Lyon.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2019 Feb; Vol. 201 (2), pp. 315-321.
DOI:	10.1016/j.juro.2018.08.084
Abstrakt:	Purpose: Vascular targeted photodynamic therapy with TOOKAD® is a new therapeutic option for localized prostate cancer management. The objectives of this study were to assess the feasibility of radical prostatectomy after vascular targeted photodynamic therapy and describe functional and oncologic outcomes. Materials and Methods: We retrospectively included in study 45 patients who underwent salvage radical prostatectomy after vascular targeted photodynamic therapy for recurrent prostate cancer at a total of 14 surgical centers in Europe between October 2008 and March 2017. Of the 42 radical prostatectomies performed 16 were robot-assisted, 6 were laparoscopic and 20 were open surgery. Primary end points were morbidity and technical difficulties. Secondary end points were early and intermediate postoperative functional and oncologic outcomes. Results: Median operative time was 180 minutes (IQR 150-223). Median blood loss was 200 ml (IQR 155-363). According to the surgeons the surgery was easy in 29 patients (69%) and difficult in 13 (31%). Nerve sparing was feasible in 14 patients (33%). Five postoperative complications (12%) were found, including 2 Clavien I, 2 Clavien II and 1 Clavien IIIB complications. Of the cases 13 (31%) were pT3 and 21 (50%) were pT2c. Surgical margins were positive in 13 patients (31%). Prostate specific antigen was undetectable at 6 to 12 months in 37 patients (88%). Nine patients underwent complementary radiotherapy. Four patients had final prostate specific antigen greater than 0.2 ng/ml at a median followup of 23 months (IQR 12-36). At 1 year 27 patients (64%) were completely continent (no pads) and 10 (24%) had low incontinence (1 pad). Four patients (11%) recovered potency without treatment and 23 (64%) recovered potency with appropriate treatment. Conclusions: Salvage radical prostatectomy after vascular targeted photodynamic therapy treatment was feasible and safe without difficulty for most of the surgeons.
Databáze:	MEDLINE
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