Is Salvage Surgery Effective After Failed Radiation Therapy?

If you have a recurrence of your prostate cancer after primary radiation therapy can a salvage radical prostatectomy (SRP) provide you with any benefits?  This is an important question since one-third of men who do have radiation treatment will have a recurrence.

A study by Antoni Vilaseca, MD, et al. from Memorial Sloan-Kettering Cancer Center in New York shows that there might be enough benefits to warrant SRP, especially minimally invasive SRP.

The study, which was small, evaluated 251 men who had an SRP after having failed primary treatment with external beam radiation therapy, brachytherapy (seeds), or with both.

Vilaseca evaluated the men’s survival and disease progression after having had an SRP.  She also assessed if using minimally invasive surgery (MIS or laparoscopic surgery) would reduce the common side effect, the incidence of bladder neck contracture (BNC).  BNC, which is the development of post-surgical scar tissue at the junction of the bladder outlet and the prostate gland can constrict a man’s ability to urinate.

Their analysis showed that for the men who had SRP had 5- and 10-year cancer-specific survival rates of 92% and 78%, respectively, and the 5- and 10-year overall survival rates were 87% and 64%, respectively.

They also found that the 1- and 3-year bladder neck contracture-free (BNC) survival rates were 81% and 73%, respectively.

These findings allowed the research team to conclude that the men who underwent minimally invasive surgery had significantly better BNC-free survival compared with those who had open surgery.  They also found that SRP provided good long-term oncologic outcomes.

If you are thinking about having an SRP make sure that you go only to a very experienced surgeon who has performed many SRPs.  This surgery is a very difficult because the prior radiation will have caused significant damage to the prostate gland.


Joel T. Nowak, MA, MSW wrote this Post.  Joel is the CEO/Executive Director of Cancer ABCs.  He is a Cancer Thriver diagnosed with five primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma, and the rare cancer Appendiceal cancer.