Short summary

When diagnosed with high-risk localized prostate cancer, curative treatment, in form of surgery or radiation, is offered. However, more than 40% of the patients receiving non-surgical treatment experience recurrence and only life-prolonging treatment is left. With the introduction of robot-assisted surgery, salvage prostatectomies can now be performed on this group of patients, introducing a curative treatment. In this study, we introduce salvage prostatectomy and evaluate the outcome and safety

Rationale

Every year, more than 4000 men in Denmark are diagnosed with prostate cancer. More than half of the patients have localized cancer and approximately 1800 patients receive curative intended treatment, mostly surgery or radiation therapy, up front. Depending on the cancer characteristics, recurrence will occur in at least 40% of the patients receiving non-surgical treatments and no curable standard treatment is available in Denmark at present. The patients are offered life-prolonging treatments including several lines of androgen deprivation therapy, chemotherapy and palliation. However, in a large proportion of patients, disease recurrence is clinically localized and therefore potentially curable: Salvage prostatectomy has the best likelihood of achieving local control relative to other salvage treatments. With the introduction of robot-assisted surgery, salvage prostatectomy has been used experimentally in other countries with success. We want to introduce the procedure in Denmark starting up locally in Odense. With this project we want systematically to introduce salvage robot-assisted radical prostatectomy in Denmark with the purpose of describing safety and morbidity. In addition, we aim to analyze the effect of the salvage prostatectomy on the prostate cancer specific mortality. In this setup, the patients will be evaluated for this treatment option, at the multidisciplinary conferences at two centers. When indicated, the surgery will be performed at one of the Danish high volume prostate cancer centers. Collaborations with Professor Alexander Hases, from the Martini Clinic in Hamburg, Germany, and with Associate Professor Göran Ahlgren, at the Peritus Clinic in Lund, Sweden, have been established for the support of the project and surgical procedures.

Description of the cohort

Men with local prostate cancer recurrence after initial non-surgical curative treatment

Data and biological material

Demographics and disease related data from first diagnosis (such as Gleason score and tumor stage), data related to treatment and follow-up, as well as data related to the diagnostics of local cancer recurrence. After salvage prostatectomy, data on surgical complications and histology will be included and the patients are followed for 10 years with blood sampling and questionnaires regarding complications and known side effects to the surgery, as well as quality of life.

Collaborating researchers and departments

Martini Clinic, Hamburg, Germany

• Professor Alexander Hases

Peritus Clinic, Lund, Sweden

• Associate Professor Göran Ahlgren