Salvage lymph node dissection in patients with prostate cancer treated with radical prostatectomy or radiotherapy and positive choline positron emission tomography (PET/CT) scan

Otta-Oshiro, Renán Javier; Lista-Mateos, Fernando; García-Mediero, J.M.; Arranz-Arija, J.A.; Garcia-Prado, Julia; Núñez-Mora, C.

doi:10.1016/j.acuroe.2018.07.011

Cited by 1 publication

(1 citation statement)

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“…Another evidence suggesting patients with exclusive lymph node metastasis may achieve better prognosis arises from occasional sustained PSA relapse--free rates among intermediate-and high-risk patients with limited nodal disease when complete resection is obtained during primary treatment (6,(25)(26)(27)(28). Thus, patients with exclusive lymph node recurrence may be good candidates for salvage treatment with metastasis-directed therapy (MDT), resulting in complete PSA responses among a significant number of cases (9,10,13,(29)(30)(31)(32)(33)(34)(35)(36)(37). Those patients would certainly benefit of having ADT receipt (and its side--effects) spared or postponed.…”

Section: Introductionmentioning

confidence: 99%

Role of salvage lymph node dissection in patients previously treated for prostate cancer: systematic review

et al. 2021

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Prostate cancer is the most common invasive cancer in men. Radical prostatectomy (RP) is a definitive treatment option, but biochemical recurrence can reach 40%. Salvage lymphadenectomy is a relatively recent approach to oligometasis and has been rapidly diffused primarily due to improvement in imaging diagnosis and results showing possibly promising therapy. A systematic literature review was performed in March 2020, according to the PRISMA statement. We excluded studies with patients with suspicion or confirmation of visceral and / or bone metastases. A total of 27 articles were included in the study. All studies evaluated were single arm, and there were no randomized studies in the literature. A total of 1,714 patients received salvage lymphadenectomy after previous treatment for localized prostate cancer. RP was the most used initial therapeutic approach, and relapses were based on PET / CT diagnosis, with Coline-11C being the most widely used radiopharmaceutical. Biochemical response rates ranged from 0% to 80%. The 5 years -Free Survival Biochemical recurrence was analyzed in 16 studies with rates of 0% up to 56.1%. The articles do not present high levels of evidence to draw strong conclusions. However, even if significant rates of biochemical recurrence are not evident in all studies, therapy directed to lymph node metastases may present good oncological results and postpone the onset of systemic therapy. The long-term impact in overall survival and quality of life, as well as the best strategies for case selection remains to be determined.

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