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A reappraisal of the role of vesicourethral anastomosis biopsy in patient candidates for salvage radiation therapy after radical prostatectomy (Articolo in rivista)

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A reappraisal of the role of vesicourethral anastomosis biopsy in patient candidates for salvage radiation therapy after radical prostatectomy (Articolo in rivista) (literal)

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Roscigno M. 1, Cozzarini C. 2, Scattoni V. 1, Bertini R. 1, Da Pozzo L. 1, Pasta A. 1, Montorsi F. 1, Bolognesi A. 2, Fiorino C. 3, Colombo R. 1, Fazio F. 2,4,5, Rigatti P. 1 (2007)
A reappraisal of the role of vesicourethral anastomosis biopsy in patient candidates for salvage radiation therapy after radical prostatectomy
in Radiotherapy and oncology
(literal)

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Roscigno M. 1, Cozzarini C. 2, Scattoni V. 1, Bertini R. 1, Da Pozzo L. 1, Pasta A. 1, Montorsi F. 1, Bolognesi A. 2, Fiorino C. 3, Colombo R. 1, Fazio F. 2,4,5, Rigatti P. 1 (literal)

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1. Department of Urology 2. Department of Radiation Oncology 3. Department of Medical Physics 4. IBFM CNR 5. University Milano-Bicocca, Vita-Salute University, Milan, Italy (literal)

Titolo

A reappraisal of the role of vesicourethral anastomosis biopsy in patient candidates for salvage radiation therapy after radical prostatectomy (literal)

Abstract

BACKGROUND AND PURPOSE: To investigate the usefulness of vesicourethral anastomotic biopsy (VUBx) in patients who are candidates for salvage radiotherapy (SalvRT) after radical prostatectomy (RRP). MATERIAL AND METHODS: From 1992 to 2001, 98 patients with a PSA failure (PSAf) after RRP underwent SalvRT to the prostatic bed (median dose 70Gy). In 50/98 patients the VUBx was positive, in 26 negative; 22 patients underwent SalvRT without a prior VUBx. The prognostic impact on biochemical disease-free survival (bNEDs) of histologic confirmation of the local failure was evaluated retrospectively. RESULTS: In the 40 patients with pre-RT PSA0.9ng/mL, no additional prognostic information derived from the VUBx, while, for higher PSA values, a positive histology resulted as a covariate independently predictive of post-RT outcome (5-year bNEDs: 74% vs 42% in the 35 and 23 patients with a positive or negative/not performed VUBx, respectively, P=.03), together with pT, pre-RT PSA 1.5ng/mL, and PSA doubling time. CONCLUSIONS: In case of PSAf after RRP, VUBx before SalvRT seems unnecessary for PSA0.9ng/mL. For higher values, a positive VUBx seems to always justify a SalvRT, which may not be recommendable, given the nonnegligible risk of an already micrometastatic disease, if the biopsy results are negative. (literal)

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