title: Complete PSA Remission without Adjuvant Therapy after Secondary Lymph Node Surgery in Selected Patients with Biochemical Relapse after Radical Prostatectomy and Pelvic Lymph Node Dissection.
abstract: Introduction. To evaluate whether secondary resection of lymph node (LN) metastases (LNMs) can result in PSA remission, we analysed the PSA outcome after resection of LNM detected on PET/CT in patients with biochemical failure. Materials and Methods. 11 patients with PSA relapse (mean 3.02 ng/mL, range 0.5-9.55 ng/mL) after radical prostatectomy without adjuvant therapy were included. Suspicious LN (1-3) detected on choline PET/CT and nearby LN were openly dissected (09/04-02/11). The PSA development was examined. Histological and PET/CT findings were compared. Results. 9 of 10 patients with histologically confirmed LNM showed a PSA response. 4 of 9 patients with single LNM had a complete permanent PSA remission (mean followup 31.8, range 1-48 months). Of metastasis-suspicious LNs (14) 12 could be histologically confirmed. The additionally removed 25 LNs were all correctly negative. Conclusions. The complete PSA remissions after secondary resection of single LNM argue for a feasible therapeutic benefit without adjuvant therapy. For this purpose the choline PET/CT is in spite of its limitations currently the most reliable routinely available diagnostic tool.
authors.affiliation: Department of Urology and Paediatric Urology, Hospital Oldenburg, 26133 Oldenburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Winter
authors.forename: Jens
authors.initials: J
authors.lastname: Uphoff
authors.forename: Rolf-Peter
authors.initials: RP
authors.lastname: Henke
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Wawroschek