Salvage surgery plus androgen deprivation for radioresistant prostatic adenocarcinoma.

We report on 34 patients with persistent local radiation resistant prostate cancer who underwent salvage surgical resection and hormonal deprivation. Initially, salvage prostatectomy was done in 11 patients but in 1 disease recurred locally and cystectomy was performed, for a total of 24 patients undergoing cystoprostatectomy. There were no postoperative complications in the prostatectomy group and the average postoperative stay was 7.6 days (range 6 to 12 days). Of 11 patients 4 (36%) are completely continent. There were 2 complications in the cystoprostatectomy group (1 small bowel obstruction and 1 prolonged ileus). The average postoperative stay without complication was 11 days (range 7 to 16 days). Of the 34 patients 24 (71%) are alive without radiographic evidence of disease, including 2 with detectable prostate specific antigen values at a mean of 53 months after surgery (range 25 to 93 months). Of the patients 3 (9%) are alive with radiographically evident recurrent disease (mean 53 months, range 49 to 77 months) and 7 (21%) are dead of disease (mean 52 months, range 20 to 120 months).