Universität zu Köln

Porres, D., Pfister, D., Thissen, A., Kuru, T. H., Zugor, V., Buettner, R., Knuechel, R., Verburg, F. A. and Heidenreich, A. (2017). The role of salvage extended lymph node dissection in patients with rising PSA and PET/CT scan detected nodal recurrence of prostate cancer. Prostate Cancer Prostatic Dis., 20 (1). S. 85 - 93. LONDON: NATURE PUBLISHING GROUP. ISSN 1476-5608

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Abstract

BACKGROUND: Non-prostatic bed recurrence of prostate cancer (PCa) is usually treated with androgen deprivation therapy (ADT). We analyzed the impact of salvage extended lymph node dissection (sLND) on cancer control in patients with rising PSA and lymph node (LN) metastases. METHODS: Between 2009 and 2016 we performed sLND in 87 patients with biochemical recurrence (BCR) and positive LNs on (FEC)-F-18 and Ga-68-PSMA positron emission tomography/X-ray computer tomography (PET/CT) after primary treatment (PT) of PCa. Intra- and postoperative complications according to Clavien-Dindo were assessed and the rates of biochemical response (BR), BCR-free and clinical recurrence (CR)-free survival, as well as time to initiation of systemic treatment were evaluated. RESULTS: Mean age of patients and mean PSA at sLND was 66.7 years (46-80 years) and 2.63 ng ml(-1) (1.27-3.75 ng ml(-1)), respectively. With 87.4% radical prostatectomy (RP) was the most common PT. In all, 57.9% of patients additionally underwent adjuvant/salvage radiation therapy (RT) and 18.4% received ADT before sLND. Complete BR (cBR) was diagnosed in 27.5% of patients and incomplete BR in 40.6%. In total, 62.2% of patients remained without ADT at follow-up. With a median follow-up of 21 months (1-75 months), the cancer-specific mortality rate was 3.7%. The 3-year BCR-free, systemic therapy-free and CR-free survival rates for patients with cBR were 69.3%, 77.0% and 75%, respectively. CONCLUSIONS: sLND can be performed without significant complications and achieves an immediate BR, thus allowing a significant postponement of systemic therapy in selected patients with BCR and nodal recurrence of PCa. Therefore, sLND following 68Ga-PSMA PET/CT should be considered as part of a multimodal diagnostic and treatment concept for selective patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Porres, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Thissen, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuru, T. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zugor, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buettner, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Knuechel, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Verburg, F. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-239350
DOI:	10.1038/pcan.2016.54
Journal or Publication Title:	Prostate Cancer Prostatic Dis.
Volume:	20
Number:	1
Page Range:	S. 85 - 93
Date:	2017
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1476-5608
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EMISSION TOMOGRAPHY/COMPUTERIZED TOMOGRAPHY; RADICAL RETROPUBIC PROSTATECTOMY; ANDROGEN-DEPRIVATION THERAPY; GA-68-LABELED PSMA LIGAND; BIOCHEMICAL RECURRENCE; CURATIVE TREATMENT; ADJUVANT THERAPY; EAU GUIDELINES; LYMPHADENECTOMY; METASTASIS Multiple languages Oncology; Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23935