Extended Salvage Pelvic Lymph Node Dissection in Patients with Recurrent Prostate Cancer

الملخص EN

Background.

Treatment of patients with a biochemical recurrence (BCR) of prostate cancer (PCa) is generally difficult and without valid treatment options.

Since 2004 we have been developing therapeutic possibilities for these patients.

Methods.

We retrospectively analyzed a cohort of 41 patients with a BCR of PCa and a mean followup of 40.3±20.8 months.

Group 1 (n=10): salvage radical prostatectomy (sRP) with SePLND (salvage extended pelvic lymph nodes dissection) (initial treatment: combined brachytherapy).

Group 2 (n=22): SePLND (initial treatment: radical prostatectomy (RP)).

Group 3 (n=9): SePLND (initial treatment: RP and adjuvant radiation therapy (RT)).

We observed PSA, PSA-velocity, localization of LNs and LNs+, BCR-free period, and BR (biochemical response).

Results.

Group 1: 60% with BCR-freedom (mean 27.2 months).

Group 2: 63.6% with BCR-freedom (mean 17.5 months).

Group 3: 33.3% with BCR-freedom (mean 17.6 months).

In total, BCR-freedom was observed in 23 of 41 patients (56.1%) after salvage surgery.

75.6% of all patients showed a BR.

765 LNs were removed and 14.8% of these were LN+.

Conclusions.

The BCR-free period and BR are comparable in all three groups.

Sensibility to ADT can be reestablished and prolonged as a result of SePLND.

Multicenter studies are needed for a reliable output.