EAU 2019: Long-term Oncologic Outcomes of Patients Treated with Salvage Lymph Node Dissection for Nodal Recurrence of Prostate Cancer
Dr. Bravi, a researcher from the Division of Oncology at URI in Milan Italy, presents his group’s data on long-term oncologic outcomes of patients undergoing salvage lymph node dissection (SLND) for treatment of nodal recurrences. Overall, their study consisted of 605 patients treated with SLND at 11 tertiary referral centers in Europe. Primary and secondary outcomes were biochemical recurrence, clinical recurrence, and cancer-specific mortality, respectively.
The median age at the time of salvage LND was 66 years, of which survival analysis was conducted for patients at 8, 10 and 12 years post-salvage surgery. Similar trends in all three metrics of progression (i.e. biochemical recurrence, clinical recurrence, and cancer-specific mortality) were observed, suggesting little impact of SLND on controlling prostate cancer recurrence.
Bravi notes that, in multivariate models, pathologic Gleason grade 8-10 at the time of radical prostatectomy, increasing number of positive spots on the PET/CT scan, retroperitoneum involvement, and a number of positive nodes removed at SLND to be predictive of higher cancer-specific mortality.
Overall, Bravi and colleagues assert that SLND did not provide a long-term benefit in patients with nodal recurrence. Even further, the main cause of death in this cohort was prostate cancer-specific mortality, with little benefit to overall mortality. These findings support a need for further management strategies for these patients.
Presented by: Maxwell Towe, Prostate Cancer and Men's Health Fellow, University of California, Irvine, Department of Urology, Orange, United States
Written by: Linda My Huynh, a Senior Clinical Research Coordinator (Department of Urology, University of California-Irvine) and medical writer for UroToday.com. at the 34th European Association of Urology (EAU 2019) #EAU19, conference in Barcelona, Spain from March 15-19, 2019.