Encouraging results of the world’s largest propensity matched comparison of salvage robot-assisted radical prostatectomy (RARP) after focal and whole gland nonsurgical primary therapy from the UK group has been published in the European Urology Open Science.
Nonsurgical primary treatment for prostate cancer (PCa) includes whole gland therapy such as radiotherapy or brachytherapy, and focal gland therapy such as high-intensity focused ultrasound (HIFU), cryotherapy, or electroporation.
The primary objective was to compare perioperative, oncological, and functional outcomes of sRARP with primary RARP, and the secondary one was to compare outcomes between sRARP after whole and focal gland therapy.
Salvage RARP has similar perioperative outcomes to primary RARP with inferior potency rates. Post–focal therapy sRARP has similar recurrence and continence rates to primary RARP. Post–whole gland therapy, complication, and recurrence rates are higher, with a higher risk of urinary incontinence.
It is important for urologists to counsel patients regarding focal treatments and salvage robotic prostatectomy. It is good news for patients undergoing focal therapy, as they can rest assured that a plan B is still available to them with an option for radical treatment later.
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