title: [Extended salvage pelvic and retroperitoneal lymph node dissection due to prostate cancer relapse].
abstract: Treatment of a biochemical prostate cancer relapse represents a difficult clinical dilemma, which has remained without a definitive solution so far. Based on clinical studies, we combine radical prostatectomy with extended pelvic lymph node dissection in intermediate and high risk patients as a routine procedure at our clinic. In this paper, we report on a case of extended salvage lymphadenectomy performed due to biochemical prostate cancer recurrence. The 56-year-old patient came to our clinic in April 2012 with a finding of lymph node metastasis according to PET-CT imaging. Laparoscopic radical retropubic prostatectomy with lymphadenectomy had been performed in 2008 [pT3a, N0 (0/4), M0, R0, GS 5+4=9, iPSA 26.67 ng/mL], and followed by radiotherapy as of September 2009. The extended salvage lymphadenectomy was performed in April 2012 due to a PSA-level rise up to 24 ng/mL and the aforementioned PET-CT findings. A total of 22 lymph nodes were removed, among them 3 lymph nodes with metastases. In the fossa obturatoria on the right we identified a walnut-size lymph node relapse with tumour necrosis, which fully corresponded to the PET-CT scan. The PSA level subsequently dropped to 0.4 ng/mL postoperatively, and further to the current value of 0.02 ng/mL (August 2012).
authors: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel. dosmonov@urology.uni-kiel.de
authors: D K
authors: DK
authors: Osmonov
authors: A V
authors: AV
authors: Aksenov
authors: K-P
authors: KP
authors: Jünemann
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D014408:Biomarkers, Tumor / Q000097:blood; D003131:Combined Modality Therapy; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010388:Pelvis / Q000601:surgery; D049268:Positron-Emission Tomography; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012187:Retroperitoneal Space / Q000601:surgery; D016879:Salvage Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen