Dr Thompson and colleagues from UCLH have just published one of the world’s first reports of salvage robotic prostatectomy after focal HIFU ablation in the journal BMC Urology in July 2020.
https://bmcurol.biomedcentral.com/articles/10.1186/s12894-020-00656-9
They found that salvage robotic surgery was generally safe and feasible to do, however that outcomes were inferior to those when surgery was performed upfront (rather than after failed focal ablation therapy). The chance of complications such as anastomotic leak or stricture was higher. The chance of cure was lower, plus the chance of recovering urinary control (continence) was less. No men recovered adequate sexual function to be able to have sexual intercourse.
The results of this study are important as they will help men considering salvage surgery to understand the risks and can inform the surgeons who counsel them regarding the side effects and risks of this salvage surgery.
Perhaps more importantly, this information may help men considering focal ablation therapy as an alternative experimental treatment to mainstream surgery/ radiation. Men considering focal therapy (especially with HIFU as in this study) need to be warned that around 10-20% fail with cancer recurrence that requires salvage surgery/ radiation, and the outcomes appear worse than if they had surgery upfront.
More studies in this area are needed, particularly regarding outcomes of salvage radiation therapy for recurrence after focal therapy.
Read more study details at:
https://bmcurol.biomedcentral.com/articles/10.1186/s12894-020-00656-9