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. 2015:2015:198543.
doi: 10.1155/2015/198543. Epub 2015 Jan 28.

Salvage pelvic lymph node dissection in recurrent prostate cancer: surgical and early oncological outcome

Tom Claeys  1 , Charles Van Praet  1 , Nicolaas Lumen  1 , Piet Ost  2 , Valérie Fonteyne  2 , Gert De Meerleer  2 , Bieke Lambert  3 , Louke Delrue  4 , Pieter De Visschere  4 , Geert Villeirs  4 , Karel Decaestecker  1
Affiliations

Salvage pelvic lymph node dissection in recurrent prostate cancer: surgical and early oncological outcome

Tom Claeys et al. Biomed Res Int. 2015.

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.

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Figures

Figure 1
Figure 1
Percentual change in PSA within 40 days postoperatively, in patients treated for oligometastatic disease.
Figure 2
Figure 2
Post-SLND ADT-free survival among patients treated for oligometastatic disease (n = 13). Projected 2-year ADT-FS is 79.5%.
See this image and copyright information in PMC

References

    1. Heidenreich A., Bastian P. J., Bellmunt J., et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013. European Urology. 2014;65(1):124–137. doi: 10.1016/j.eururo.2013.09.046. - DOI - PubMed
    1. Freedland S. J., Humphreys E. B., Mangold L. A., et al. Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. Journal of the American Medical Association. 2005;294(4):433–439. doi: 10.1001/jama.294.4.433. - DOI - PubMed
    1. Boorjian S. A., Thompson R. H., Tollefson M. K., et al. Long-term risk of clinical progression after biochemical recurrence following radical prostatectomy: the impact of time from surgery to recurrence. European Urology. 2011;59(6):893–899. doi: 10.1016/j.eururo.2011.02.026. - DOI - PubMed
    1. Simmons M. N., Stephenson A. J., Klein E. A. Natural history of biochemical recurrence after radical prostatectomy: risk assessment for secondary therapy. European Urology. 2007;51(5):1175–1184. doi: 10.1016/j.eururo.2007.01.015. - DOI - PubMed
    1. Evangelista L., Zattoni F., Guttilla A., Saladini G., Colletti P. M., Rubello D. Choline PET or PET/CT and biochemical relapse of prostate cancer: a systematic review and meta-analysis. Clinical Nuclear Medicine. 2013;38(5):305–314. - PubMed

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