Heidenreich, Axel, Bludau, Mark, Bruns, Christiane, Nestler, Tim, Porres, Daniel and Pfister, David Johannes Karl Paul (2020). Pelvic exenteration surgery in patients with locally advanced castration-naive and castration-resistant, symptomatic prostate cancer. BJU Int., 126 (3). S. 342 - 350. HOBOKEN: WILEY. ISSN 1464-410X

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Abstract

Objectives To evaluate retrospectively the surgical, symptomatic and oncological outcomes of pelvic exenteration surgery (PES) in men with significant intrapelvic complications of locally advanced castration-sensitive (CSPC) and castration-resistant prostate cancer (CRPC). Patients and Methods A total of 103 patients with locally advanced progressive and symptomatic CSPC or CRPC underwent PES (radical cystoprostatectomy, n = 71 [68.9%]; radical prostatectomy with continent vesicostomy, n = 9 [8.7%]; total exenteration, n = 23 [22.3%]). All patients underwent local staging via magnetic resonance imaging, cystoscopy and rectoscopy. Systemic staging was carried out with chest, abdominal and pelvic computed tomography scans and bone scans. Peri-operative complications were assessed according to Clavien-Dindo classification. Symptom-free and overall survival were evaluated using the Kaplan-Meier method. Statistical tests were two-tailed with a P value <0.05 taken to indicate statistical significance. Results After a median (range) follow-up of 36.5 (3-123) months, the symptom-free survival rate at 1 and 3 years was 89.2% (n = 89) and 64.1% (n = 66), respectively. The median symptom-free survival was 27.9 months. A total of 78.6% of the patients were symptom-free during their remaining lifetime. The overall survival rate at 1 and 3 years was 92.2% and 43.7%, respectively, and the median overall survival was 33.6 months. Clavien-Dindo grades 2, 3 and 4 complications developed in 31 (30.6%), 12 (11.6%) and eight patients (8.1%), respectively. Conclusion Pelvic exenteration surgery is technically feasible in well-selected patients, resulting in symptom relief in >90% of patients, covering 80% of their remaining lifetime.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Heidenreich, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bludau, MarkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruns, ChristianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nestler, TimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Porres, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfister, David Johannes Karl PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-333677
DOI: 10.1111/bju.15088
Journal or Publication Title: BJU Int.
Volume: 126
Number: 3
Page Range: S. 342 - 350
Date: 2020
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1464-410X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
EFFECTIVE PALLIATION; SURVIVAL; MARKERSMultiple languages
Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33367

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