Overview
Recurrent prostate cancer after initial treatment, particularly radiotherapy, presents a significant clinical challenge. Salvage surgery, such as radical prostatectomy, is a treatment option for radio-recurrent disease, but it is associated with potential complications and functional deficits 1.Diagnosis
Diagnosis of recurrent prostate cancer is typically based on rising prostate-specific antigen (PSA) levels after definitive therapy 1.
Further evaluation may include imaging (e.g., PET-CT) to assess the extent and location of recurrence.Management
Salvage radical prostatectomy (open or robot-assisted) is a treatment option for patients with recurrent prostate cancer after radiotherapy 1.
Functional outcomes following salvage surgery include urinary incontinence and erectile dysfunction (ED) 1.
One year post-salvage surgery, the incidence of any-grade urinary incontinence (≥1 pad/d) was 49.57%, moderate to severe incontinence (≥2 pads/d) was 24.62%, and severe incontinence (≥3 pads/d) was 17.75% 1.
The incidence of ED following salvage RP at 1-year was 73.21% 1.
The incidence of serious complications following salvage RP was 14.56%, with urethral stricture being the most common at 5.90% 1.
No significant differences in serious complications or ED were observed between open and robotic salvage RP, though moderate to severe incontinence was lower in the robotic group 1.Special Populations
No information on special populations was provided in the abstracts.Key Recommendations
Salvage radical prostatectomy is a treatment option for radio-recurrent prostate cancer 1. (Evidence: Moderate)
Patients undergoing salvage radical prostatectomy should be counseled regarding the significant risk of urinary incontinence and erectile dysfunction 1. (Evidence: Moderate)
The choice between open and robotic salvage radical prostatectomy may influence the rate of moderate to severe urinary incontinence, with robotic approaches potentially offering a lower incidence 1. (Evidence: Moderate)References
1 Zhou Y, He X, Yu Q, Zhong Q. Functional outcomes and complications following salvage radical prostatectomy for post radiotherapy recurrent prostate cancer: A meta-analysis. Medicine 2025. link