放射治疗后局部复发的前列腺癌(PCa)可以采用挽救性前列腺切除术(sRP)治疗，但具有明显的发病率。因此，欧洲泌尿科协会(EAU)指南建议根据EAU标准将sRP限定于良好预后的患者群体，但这些标准只考虑生化复发(BCR)。本研究目的是在一个大型、多中心、当代队列中测试这些标准。我们回顾性地评估了在14个转介中心接受sRP手术的1265名患者的遵从EAU标准的情况。我们的主要结局是无转移生存期(MFS)。我们纳入了1030名男性，其中221名(21.5%)完全符合EAU推荐的sRP标准，809名(78.5%)未符合标准。符合EAU标准的组显示出更好的病理和功能性结果(1年内无纸裤79% vs 63%；p<0.001)，且MFS(5年内90% vs 76%；p<0.001)、特异性抗原自由生存期(5年内55% vs 38%；p<0.001)和总生存率(5年内89% vs 84%；p=0.01)均显著优于不符合标准的组。这在Cox回归分析中得到验证，MFS的危险比为1.84，95%置信区间为1.13-2.99，p=0.01。我们发现，遵循EAU标准与BCR的风险以及更重要的术后转移的风险降低相关。患者摘要：我们研究了根据患者是否符合欧洲泌尿科协会(EAU)标准进行放射治疗后前列腺癌复发的手术切除治疗。我们发现，未符合标准的患者存在更高的转移风险，而他们受益于手术的可能性可能显著低于符合EU标准的患者。 Copyright © 2023 European Association of Urology. 由Elsevier B.V.出版。保留所有权利。

Salvage radical prostatectomy (sRP) is a potentially curative option for locally radiorecurrent prostate cancer (PCa) but is associated with significant morbidity. Therefore, the European Association of Urology (EAU) guidelines recommend restricting sRP to a favorable-prognosis group according to the EAU criteria, but these have been validated considering only biochemical recurrence (BCR). Our aim was to test these criteria in a large, multicenter, contemporary cohort. We retrospectively reviewed 1265 patients who underwent sRP at 14 referral centers (2000-2021), stratified by compliance with the EAU criteria. Our primary outcome was metastasis-free survival (MFS). We included 1030 men, of whom 221 (21.5%) fully met the EAU recommended criteria for sRP and 809 (78.5%) did not. The EAU-compliant group experienced more favorable pathological and functional outcomes (79% vs 63% wearing no pads at 1 yr; p < 0.001) and had significantly better MFS (90% vs 76% at 5 yr; p < 0.001), prostate-specific antigen-free survival (55% vs 38% at 5 yr; p < 0.001), and overall survival (89% vs 84% at 5 yr; p = 0.01). This was verified by Cox regression analysis for MFS (hazard ratio 1.84, 95% confidence interval 1.13-2.99; p = 0.01). We found that adherence to the EAU criteria is associated with a lower risk of BCR and, more importantly, of metastasis after surgery. PATIENT SUMMARY: We looked at outcomes of surgical removal of the prostate for prostate cancer recurrence after radiotherapy or other nonsurgical treatments according to whether or not patients met the European Association of Urology (EAU) criteria for this surgery. We found that men who did not meet the criteria had a higher risk of metastasis and their benefit from surgery might be significantly less than for patients who do meet the EUA criteria.Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.