by
Christina Hwang, Contributing Reporter | March 14, 2016
Pokala performing a robotic surgery
When radiation therapy isn't enough to eradicate prostate cancer, new research suggests there's a viable back up option that can be deployed.
A research team from the University of Missouri School of Medicine has determined that salvage radical prostatectomy — the surgical removal of the prostate and the surrounding tissue — can increase the chance of survival in men with prostate cancer.
The team, led by Dr. Naveen Pokala, assistant professor in the Division of Urology at the MU School of Medicine and lead author of the study, used the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database to study the survival rate of 364 men who underwent the procedure.
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“All patients had a single cancer, i.e., adenocarcinoma of the prostate, and received radiation prior to having a radical prostatectomy,” Pokala told HCB News.
What they found was that the procedure greatly increased the patient's chance for survival. A decade after the procedure, 88.6 percent of men were still alive, and after two decades 72.7 percent were still alive.
The value of a salvage radical prostatectomy is good news for cancer patients — but the procedure can be highly complex and challenging to perform due to post-radiation scarring and changes in the tissue. "There is a higher risk of developing fistulae and injuries to the surrounding structures," said Pokala, adding that the procedure should be performed by experienced surgeons in high-volume centers.
The procedure is performed in either open surgery or minimally-invasively through the utilizing of robotics, but Polaka said there have not yet been any large single-institutional studies comparing outcomes for the two approaches. However, he said some single-institutional cases have shown good results for the robotic approach.
"Prostate cancer, unfortunately, is a common cancer, and more than 27,000 men are estimated to have died from the disease in 2015," said Pokala. Having a solution for recurring cancer after radiation can bring a renewed hope and peace of mind to men living with the disease, but he says surgeons and radiation oncologists have been "tentative" in recommending salvage prostatectomy.
