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

Marco Roscigno, Cesare Cozzarini, Vincenzo Scattoni, Roberto Bertini, Luigi Da Pozzo, Alessandra Pasta, Francesco Montorsi, Angelo Bolognesi, Claudio Fiorino, Renzo Colombo, Ferruccio Fazio, Patrizio Rigatti

Research output: Contribution to journalArticle

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 70 Gy). 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 PSA ≤ 0.9 ng/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 ≤1.5 ng/mL, and PSA doubling time. Conclusions: In case of PSAf after RRP, VUBx before SalvRT seems unnecessary for PSA ≤ 0.9 ng/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.

Original languageEnglish
Pages (from-to)30-37
Number of pages8
JournalRadiotherapy and Oncology
Volume82
Issue number1
DOIs
Publication statusPublished - Jan 2007

Keywords

  • Biopsy
  • Prostate cancer
  • Salvage radiation therapy
  • Vesicourethral anastomosis

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Urology

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