Pontes J E, Montie J, Klein E, Huben R
Wayne State University, Detroit, Michigan.
Cancer. 1993 Feb 1;71(3 Suppl):976-80. doi: 10.1002/1097-0142(19930201)71:3+<976::aid-cncr2820711413>3.0.co;2-m.
Salvage surgery was done in 43 patients who did not respond to radiation therapy of prostate cancer between 1982-1991. Thirty-five patients underwent salvage prostatectomy and 8, cystoprostatectomy.
The complications were significant; four patients had rectal injuries (all closed primarily), one had a ureteral injury, and there was one perioperative death. Urinary incontinence occurred in 10 of 35 patients (30%). Pathologic step sections of the prostate showed that only 13 of 43 patients (30%) had negative surgical margins. Follow-up (range, 1-10 years) revealed that 34 patients were alive, and 9 had died. Eleven of 20 patients were alive who were followed more than 5 years. Ten patients were considered to have no evidence of disease (undetectable prostate specific antigen levels).
In selected patients, salvage surgery has a place in the treatment of prostate cancer after radiation therapy failure.
1982年至1991年间，对43例前列腺癌放射治疗无效的患者进行挽救性手术。35例行挽救性前列腺切除术，8例行膀胱前列腺切除术。
并发症严重；4例患者出现直肠损伤（均一期缝合），1例输尿管损伤，1例围手术期死亡。35例患者中有10例（30%）发生尿失禁。前列腺病理切片显示，43例患者中只有13例（30%）手术切缘阴性。随访（范围1至10年）显示，34例患者存活，9例死亡。20例随访超过5年的患者中有11例存活。10例患者被认为无疾病证据（前列腺特异性抗原水平检测不到）。
对于部分患者，挽救性手术在前列腺癌放疗失败后的治疗中占有一席之地。
