Background: Since the introduction of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging, isolated local recurrence after radical prostatectomy (RP) can be... Show moreBackground: Since the introduction of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging, isolated local recurrence after radical prostatectomy (RP) can be delineated accurately.Objective: To describe and evaluate surgical technique, biochemical response, and therapy-free survival (TFS) after salvage surgery in patients with local recurrence in the seminal vesicle bed.Design, setting, and participants: We retrospectively assessed 40 patients treated with open salvage surgery in two centres (11/2014-02/2020). All patients presented with biochemical recurrence (BCR) after RP with a singular local recurrence at PSMA PET imaging. Thirty-three (82.5%) patients received previous salvage radiation therapy.Surgical procedure: Open salvage surgery with PSMA radioguidance.Measurements: Prostate-specific antigen (PSA) nadir and percentage of patients with complete biochemical response (cBR) without further treatment (PSA < 0.2 ng/ml) after 6-16 wk were assessed. BCR-free survival and TFS were calculated using Kaplan-Meier estimates. Clavien-Dindo complications were evaluated.Results and limitations: Prior to salvage surgery, median PSA was 0.9 ng/ml (interquartile range [IQR]: 0.5-1.7 ng/ml). Postoperatively, median PSA nadir was 0.1 ng/ml (IQR: 0-0.4 ng/ml). In 31 (77.5%) patients, cBR was observed. During the median follow-up of 24.4 months, 22 (55.0%) patients experienced BCR and 12 (30.0%) received further therapy. At 1 yr of follow-up, BCR-free survival rate was 62.2% and TFS rate was 88.3%. Three (7.5%) Clavien-Dindo grade III complications were observed. The main limitations are the retrospective design, short follow-up, and lack of a control group.Conclusions: Salvage surgery of local recurrence within the seminal vesicle bed is feasible. It may present an opportunity in selected, locally recurrent patients to prolong BCR-free survival and increase TFS. Further studies are needed to confirm our findings.Patient summary: We looked at the outcomes from prostate cancer patients with locally recurrent disease after radical prostatectomy and radiotherapy. We found that surgery in well-selected patients may be an opportunity to prolong treatment-free survival. (C) 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved. Show less
We present VIsible Multi-Object Spectrograph (VIMOS) observations of a galaxy quintuply imaged by the Frontier Fields galaxy cluster RXC J2248.7-4431 . This sub-, high- galaxy has been recently... Show moreWe present VIsible Multi-Object Spectrograph (VIMOS) observations of a galaxy quintuply imaged by the Frontier Fields galaxy cluster RXC J2248.7-4431 . This sub-, high- galaxy has been recently discovered by Monna et al. (2013) using dropout techniques with the 16-band HST photometry acquired as part of the Cluster Lensing And Supernova survey with Hubble (CLASH). Obtained as part of the CLASH-VLT survey, the VIMOS medium-resolution spectra of this source show a very faint continuum between 8700 å and 9300 å and a prominent emission line at 8643 , which can be readily identified with Lyman- at . The emission line exhibits an asymmetric profile, with a more pronounced red wing. The rest-frame equivalent width of the line is , relatively well constrained thanks to the detection of the UV continuum, which is rarely achieved for a sub- galaxy at this redshift. After correcting formagnification, the star formation rate (SFR) estimated from the Ly line is SFRLyyr and that estimated from the UV data is SFRUVyr. We estimate that the effective radius of the source is kpc, which implies a star formation surface mass density yrkpc and, using the Kennicutt-Schmidt relation, a gas surface mass density pc. Our results support the idea that this magnified, distant galaxy is a young and compact object with luminosity at , when the Universe was just 1 Gyr old, with a similar amount of mass in gas and stars. In the spirit of the Frontier Fields initiative, we also publish the redshifts of several multiply imaged sources and other background objects, which will help improving the strong-lensing model of this galaxy cluster. This work is based on data collected at ESO VLT (prog.ID 186.A-0798) and at NASA HST. Show less
