Salvage pelvic lymph node dissection in recurrent prostate cancer: Surgical and early oncological outcome - Abstract

METHODOLOGY: Seventeen patients with prostate-specific antigen (PSA) rise following local treatment for prostate cancer with curative intent underwent open or minimally invasive salvage pelvic lymph node dissection (SLND) for oligometastatic disease (< 4 synchronous metastases) or as staging prior to salvage radiotherapy.

Biochemical recurrence after complete biochemical response (cBR) was defined as 2 consecutive PSA increases >0,2 ng/mL; and after incomplete biochemical response as 2 consecutive PSA rises. Newly found metastasis on imaging defined clinical progression (CP). Palliative androgen deprivation therapy (ADT) was initiated if >3 metastases were detected or if patients became symptomatic. Kaplan-Meier statistics were applied.

RESULTS: Clavien-Dindo grade 1, 2, 3a, and 3b complications were seen in 6, 1, 1, and 2 patients, respectively. Median follow-up time was 22 months. Among 13 patients treated for oligometastatic disease, 8 (67%) had a PSA decline, with 3 patients showing cBR. Median PSA progression-free survival (FS) was 4.1 months and median CP-FS 7 months. Three patients started ADT, resulting in a 2-year ADT-FS rate of 79.5%.

CONCLUSION: SLND is feasible, but postoperative complication rate seems higher than that for primary LND. Biochemical and clinical response duration is limited, but as part of an oligometastatic treatment regime it can defer palliative ADT.

Written by:
Claeys T, Van Praet C, Lumen N, Ost P, Fonteyne V, De Meerleer G, Lambert B, Delrue L, De Visschere P, Villeirs G, Decaestecker K.   Are you the author?
Department of Urology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium; Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, 9000 Ghent, Belgium; Department of Nuclear Medicine, Ghent University Hospital, 9000 Ghent, Belgium; Department of Radiology, Ghent University Hospital, 9000 Ghent, Belgium.

Reference: Biomed Res Int. 2015;2015:198543.
doi: 10.1155/2015/198543

PubMed Abstract
PMID: 25695051 Prostate Cancer Section