We aim to evaluate the efficacy of salvage lymph node dissection (SLND) for nodal recurrent prostate cancer after primary treatment. We also provide a review of the diagnostic performance of next-generation sequencing (next-generation imaging (NGI)) radiotracers in the salvage setting.
Most studies evaluating SLND include a heterogeneous population with a small sample size and are retrospective in design. The 5-year clinical recurrence-free and cancer-specific survival following SLND are 26-52% and 57-89%, respectively, among prospective studies. NGI improves accuracy in detecting nodal recurrence compared to conventional CT, with PMSA PET-CT showing the most promise. However, limited studies exist comparing imaging modalities and performance is variable at low PSA values. SLND is a promising treatment option, but more prospective data are needed to determine the ideal surgical candidate and long-term oncologic outcomes. More studies comparing different NGI are needed to determine the best imaging modality in patients who may be candidates for salvage treatment.
Current urology reports. 2020 Nov 07*** epublish ***
Hannah McCloskey, Jesse Jacobs, Ibardo Zambrano, Theodore Moore, Amir H Khandani, Marc A Bjurlin
Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC, USA., Department of Radiology, Division of Molecular Imaging and Therapeutics (Mit), University of North Carolina, Chapel Hill, NC, USA., Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. .