{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T07:40:07Z","timestamp":1756798807950,"version":"3.44.0"},"reference-count":18,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SJU"],"abstract":"<jats:p>Objective: To evaluate oncological and functional outcomes after salvage robotic-assisted laparoscopic radical prostatectomy (sRALP).\nMaterial and methods: We included 60 patients, consecutively treated with sRALP for radiorecurrent prostate cancer (PCa) at Oslo University Hospital (OUS). Data were collected from our PCa registry and electronic patient journal (EPJ). PSA persistence was defined as PSA \u2265 0.1 ng\/mL 6 weeks postoperatively, and these patients were not included in the survival analysis. Logistic regression was used to find \u00advariables associated with PSA persistence. Biochemical recurrence (BCR) was defined as PSA \u2265 0.2 ng\/mL. Cox regression was used to analyse BCR-free survival. Urinary leakage was graded as minor, moderate or severe. Complications were classified according to the Clavien-Dindo classification.\nResults: Twenty-three patients (38%) had persistent PSA. With a median follow-up of 82 months (interquartile range [IQR] 48\u2013101 months), 16 patients (28%) had no BCR or start of androgen deprivation therapy (ADT). Twelve patients (20%) were deceased, 10 (17%) from PCa.\nPreoperative PSA was statistically significantly associated with persistent PSA (p = 0.01). International Society of Urological Pathology (ISUP) Grade Group 5 showed a statistically significant association with BCR (p = 0.01). Anastomosis leakage and strictures occurred in 27 (45%) and 15 patients (33%), respectively. Twenty-nine patients (48%) suffered severe urinary leakage, whilst 11 patients (24%) had moderate urinary leakage. Eleven patients (18%) received artificial urinary sphincters, and 10 patients (17%) underwent urinary diversion. Two patients suffered a grade 4 complication (sepsis), whilst 25 patients (41%) had grade 3 complications, most of which were related to intervention in the urinary system.\u00a0\nConclusion: Salvage RALP for radiorecurrent PCa has limited effect on oncological outcomes. Patients should be thoroughly informed about the high risk of urinary leakage and severe surgical complications.<\/jats:p>","DOI":"10.2340\/sju.v60.44585","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T07:15:04Z","timestamp":1756797304000},"page":"158-163","source":"Crossref","is-referenced-by-count":0,"title":["Oncological outcomes and complications after salvage robotic-assisted laparoscopic radical prostatectomy (sRALP)"],"prefix":"10.2340","volume":"60","author":[{"given":"Andreas","family":"Habberstad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siril","family":"Stokke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars Magne","family":"Eri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lien My","family":"Diep","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f8rn","family":"Brennhovd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktor","family":"Berge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"124875","doi-asserted-by":"crossref","unstructured":"Pompe RS, Tilki D. Complications after salvage radical prostatectomy: vesicourethral anastomosis leaks and possible prevention. Transl Androl Urol. 2017;6(5):994\u2013996. https:\/\/doi.org\/10.21037\/tau.2017.03.66","DOI":"10.21037\/tau.2017.03.66"},{"key":"124876","doi-asserted-by":"crossref","unstructured":"Heidenreich A, Richter S, Thuer D, et al. Prognostic parameters, complications, and oncologic and functional outcome of salvage radical prostatectomy for locally recurrent prostate cancer after 21st-century radiotherapy. Eur Urol. 2010;57(3):437\u2013443. https:\/\/doi.org\/10.1016\/j.eururo.2009.02.041","DOI":"10.1016\/j.eururo.2009.02.041"},{"key":"124877","doi-asserted-by":"crossref","unstructured":"Perera M, Papa N, Roberts M, et al. Gallium-68 prostate-specific membrane antigen positron emission tomography in advanced prostate cancer-updated diagnostic utility, sensitivity, specificity, and distribution of prostate-specific membrane antigen-avid lesions: a systematic review and meta-analysis. Eur Urol. 2020;77(4):403\u2013417. https:\/\/doi.org\/10.1016\/j.eururo.2019.01.049","DOI":"10.1016\/j.eururo.2019.01.049"},{"key":"124878","doi-asserted-by":"crossref","unstructured":"Jones JS. Radiorecurrent prostate cancer: an emerging and largely mismanaged epidemic. Eur Urol. 2011;60(3):411\u2013412. https:\/\/doi.org\/10.1016\/j.eururo.2011.01.007","DOI":"10.1016\/j.eururo.2011.01.007"},{"key":"124879","doi-asserted-by":"crossref","unstructured":"Stattin P. How to improve cancer care by use of guidelines and quality registers. Scand J Urol. 2024;59:190\u2013192. https:\/\/doi.org\/10.2340\/sju.v59.42272","DOI":"10.2340\/sju.v59.42272"},{"key":"124880","doi-asserted-by":"crossref","unstructured":"Marra G, Marquis A, Yanagisawa T, et al. Salvage radical prostatectomy for recurrent prostate cancer after primary nonsurgical treatment: an updated systematic review. Eur Urol Focus. 2023;9(2):251\u2013257. https:\/\/doi.org\/10.1016\/j.euf.2023.01.013","DOI":"10.1016\/j.euf.2023.01.013"},{"key":"124881","doi-asserted-by":"crossref","unstructured":"Heidenreich A, Bastian PJ, Bellmunt J, et al. EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol. 2014;65(2):467\u2013479. https:\/\/doi.org\/10.1016\/j.eururo.2013.11.002","DOI":"10.1016\/j.eururo.2013.11.002"},{"key":"124882","doi-asserted-by":"crossref","unstructured":"Qvigstad LF, Eri LM, Lien MD, et al. Reduction of lower urinary tract symptoms in prostate cancer patients treated with robot assisted laparoscopic prostatectomy. Scand J Urol. 2024;59:121\u2013125. https:\/\/doi.org\/10.2340\/sju.v59.40070","DOI":"10.2340\/sju.v59.40070"},{"key":"124883","doi-asserted-by":"crossref","unstructured":"Chen RC, Chang P, Vetter RJ, et al. Recommended patient-reported core set of symptoms to measure in prostate cancer treatment trials. J Natl Cancer Inst. 2014;106(7):dju132. https:\/\/doi.org\/10.1093\/jnci\/dju132","DOI":"10.1093\/jnci\/dju132"},{"key":"124884","doi-asserted-by":"crossref","unstructured":"Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205\u2013213. https:\/\/doi.org\/10.1097\/01.sla.0000133083.54934.ae","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"124885","doi-asserted-by":"crossref","unstructured":"Perera M, Vilaseca A, Tin AL, et al. Morbidity of salvage radical prostatectomy: limited impact of the minimally invasive approach. World J Urol. 2022;40(7):1637\u20131644. https:\/\/doi.org\/10.1007\/s00345-022-04031-1","DOI":"10.1007\/s00345-022-04031-1"},{"key":"124886","doi-asserted-by":"crossref","unstructured":"Mandel P, Steuber T, Ahyai S, et al. Salvage radical prostatectomy for recurrent prostate cancer: verification of European Association of Urology guideline criteria. BJU Int. 2016;117(1):55\u201361. https:\/\/doi.org\/10.1111\/bju.13103","DOI":"10.1111\/bju.13103"},{"key":"124887","doi-asserted-by":"crossref","unstructured":"Wedde TB, Smaastuen MC, Vatne K, et al. External beam radiotherapy of prostate cancer with or without high dose-rate brachytherapy: the Norwegian experience with long-term urinary and bowel adverse effects. Scand J Urol. 2023;58:68\u201375. https:\/\/doi.org\/10.2340\/sju.v58.9571","DOI":"10.2340\/sju.v58.9571"},{"key":"124888","doi-asserted-by":"crossref","unstructured":"Ribeiro L, Stonier T, Stroman L, et al. Is the toxicity of salvage prostatectomy related to the primary prostate cancer therapy received? J Urol. 2021;205(3):791\u2013799. https:\/\/doi.org\/10.1097\/JU.0000000000001382","DOI":"10.1097\/JU.0000000000001382"},{"key":"124889","doi-asserted-by":"crossref","unstructured":"Ogaya-Pinies G, Kadakia Y, Palayapalayam-Ganapathi H, et al. Use of scaffolding tissue biografts to bolster vesicourethral anastomosis during salvage robot-assisted prostatectomy reduces leak rates and catheter times. Eur Urol. 2018;74(1):92\u201398. https:\/\/doi.org\/10.1016\/j.eururo.2016.10.004","DOI":"10.1016\/j.eururo.2016.10.004"},{"key":"124890","doi-asserted-by":"crossref","unstructured":"Kaffenberger SD, Keegan KA, Bansal NK, et al. Salvage robotic assisted laparoscopic radical prostatectomy: a single institution, 5-year experience. J Urol. 2013;189(2):507\u2013513. https:\/\/doi.org\/10.1016\/j.juro.2012.09.057","DOI":"10.1016\/j.juro.2012.09.057"},{"key":"124891","unstructured":"Anderson KM, Higuchi TT, Flynn BJ. Management of the devastated posterior urethra and bladder neck: refractory incontinence and stenosis. Transl Androl Urol. 2015;4(1):60\u201365."},{"key":"124892","doi-asserted-by":"crossref","unstructured":"Carlsson S, Bock D, Lantz A, et al. Salvage radiotherapy after radical prostatectomy: functional outcomes in the LAPPRO trial after 8-year follow-up. Scand J Urol. 2023;58:11\u201319. https:\/\/doi.org\/10.2340\/sju.v58.7318","DOI":"10.2340\/sju.v58.7318"}],"container-title":["Scandinavian Journal of Urology"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/download\/44585\/51274","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/download\/44585\/51274","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T07:15:10Z","timestamp":1756797310000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/SJU\/article\/view\/44585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":18,"URL":"https:\/\/doi.org\/10.2340\/sju.v60.44585","relation":{},"ISSN":["2168-1813"],"issn-type":[{"value":"2168-1813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,2]]}}}