Salvage robotic assisted laparoscopic radical prostatectomy: Indications and outcomes

Objectives: Salvage robotic assisted laparoscopic radical prostatectomy (SRALP) has now become a feasible alternative to open prostatectomy in experienced hands. Herein we review the urologic literature for the indications and outcomes of SRALP. Methods: A comprehensive review of the peer reviewed literature was performed for reported cases of salvage robotic and open prostatectomy, with emphasis being on comparing oncologic outcomes. Results: Salvage prostatectomy, whether open or robotic, is a viable alternative for treatment of recurrent, localized, non-metastatic prostate cancer after failed primary radiotherapy. Although few reports of salvage robotic prostatectomy have been published with limited long-term follow-up, initial oncologic results seem at least comparable to the salvage open prostatectomy series. SRALP should be performed by centers with a dedicated and well experienced robotic urologic oncology program. Conclusions: SRALP is a feasible surgical treatment option for patients with recurrence after primary radiotherapy with preliminary oncologic outcomes comparable to the open approach. Further long-term follow-up is needed to validate these results.