title: Salvage pelvic lymph node dissection in recurrent prostate cancer: surgical and early oncological outcome.
abstract: METHODS
  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%.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Tom
authors.identifier: 0000-0001-6677-6846
authors.initials: T
authors.lastname: Claeys
authors.affiliation: Department of Urology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Charles
authors.initials: C
authors.lastname: Van Praet
authors.affiliation: Department of Urology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Nicolaas
authors.initials: N
authors.lastname: Lumen
authors.affiliation: Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Piet
authors.initials: P
authors.lastname: Ost
authors.affiliation: Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Valérie
authors.initials: V
authors.lastname: Fonteyne
authors.affiliation: Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Gert
authors.initials: G
authors.lastname: De Meerleer
authors.affiliation: Department of Nuclear Medicine, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Bieke
authors.initials: B
authors.lastname: Lambert
authors.affiliation: Department of Radiology, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Louke
authors.initials: L
authors.lastname: Delrue
authors.affiliation: Department of Radiology, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: De Visschere
authors.affiliation: Department of Radiology, Ghent University Hospital, 9000 Ghent, Belgium.
authors.forename: Geert
authors.initials: G
authors.lastname: Villeirs
authors.affiliation: Department of Urology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Karel
authors.initials: K
authors.lastname: Decaestecker
mesh_terms: D000368:Aged; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D016879:Salvage Therapy / Q000379:methods
chemical_list: D017430:Prostate-Specific Antigen