Universität zu Köln

Kanzelmeyer, Saskia, Bludau, Mark, Pfister, David Johannes Karl Paul and Heidenreich, Axel (2022). Pelvic exenteration in patients with locally advanced, symptomatic castration-resistant prostate cancer. Urologe, 61 (2). S. 167 - 173. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0563

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Abstract

Goal The retrospective evaluation of clinical outcomes after palliative pelvic exenteration (PPE) in patients with subvesical and supravesical complications due to symptomatic locally advanced castration-resistant prostate cancer (CRPC). Patients and methods In all, 84 patients with locally advanced and symptomatic CRPC underwent radical cystoprostatectomy (n = 71, 83.3%) or anterior and posterior exenteration (n = 13, 16.7%). Local staging was done via pelvic MRI (magnetic resonance imaging), cystoscopy, and rectoscopy. Systemic staging was performed by computed tomography of the thorax, abdomen pelvis, and skeletal scintigraphy. Perioperative complications were evaluated using the Clavien-Dindo classification. The primary study objective was symptom-free survival defined as absence of lower or upper urinary tract symptoms and absence of endoluminal or percutaneous intervention. Results After a median follow-up of 43.5 (3-139) months, symptom-free survival at 1 and 3 years was 95.2% and 86.7%, respectively. In all, 86.7% of patients remained symptom-free for their remaining lifetime with respect to local symptoms. Overall survival at 1 and 3 years was 92.9% and 54.7%, respectively. Clavien-Dindo grade 2, 3, and 4 complications occurred in 19 (22.6%), 7 (8.3%), and 3 (3.6%) patients, respectively. Conclusion With adequate patient selection, PPE is possible with a low complication rate and results in significant symptom relief in the lower or upper genitourinary tract in about 90% of patients, of whom more than 80% remain symptom-free for the remainder of their lives. Prerequisites for favorable surgical outcomes are patient selection, an interdisciplinary approach, and appropriate surgical expertise.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kanzelmeyer, Saskia UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Mark UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, David Johannes Karl Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-571826
DOI:	10.1007/s00120-021-01619-0
Journal or Publication Title:	Urologe
Volume:	61
Number:	2
Page Range:	S. 167 - 173
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0563
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EFFECTIVE PALLIATION; SURVIVAL; MARKERS Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57182