title: [Salvage lymphadenectomy in patients with prostate cancer recurrence: A review].
abstract: BACKGROUND
  Salvage extended pelvic lymph node dissection (salvage ePLND) in patients with prostate cancer (PCa) biochemical recurrence is an alternative to the commonly used androgen deprivation therapy (ADT) and/or chemotherapy. Small patient number, insufficient accuracy of contemporary imaging methods for lymph node relapse diagnostics, and the lack of prospective data present limiting factors for a wider application of salvage ePLND. The purpose of this publication is to review German and European data and studies on the subject of salvage ePLND and to discuss future perspectives.
  
  
  METHODS
  We analyzed available studies up to October 2014 from Medline with the keywords "salvage lymph node dissection prostate cancer".
  
  
  RESULTS
  A total of 51 publications since 1984 (up to October 2014) meeting the search criteria were found. Ten of these were studies that analyzed the results of salvage ePLND. Of these 10 studies, 6 originated from German clinics. Furthermore, among these 51 publications, there were 2 clinical case reports (1 from Germany) and 3 reviews (none from Germany).
  
  
  CONCLUSIONS
  The available data show insufficient evidence-based validity. There have been no prospective studies and just one multicenter study. However, single-center retrospective studies have shown promising results. Salvage ePLND leads to biochemical remission, freedom from clinical recurrence, and probably also to renewed response to ADT in patients with castration-resistant PCa. Multicenter prospective studies should be conducted in Germany (where most of the available studies have been performed). The selection of patients should be analyzed in order to identify clear selection criteria for salvage ePLND.
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 3, Haus 18, 24105, Kiel, Deutschland.
authors.forename: D K
authors.initials: DK
authors.lastname: Osmonov
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 3, Haus 18, 24105, Kiel, Deutschland. alexey.aksenov@uksh.de.
authors.forename: A V
authors.initials: AV
authors.lastname: Aksenov
authors.affiliation: Klinik für Urologie, Universitätsklinik Freiburg, Freiburg, Deutschland.
authors.forename: C A
authors.initials: CA
authors.lastname: Jilg
authors.affiliation: Klinik für Urologie, Universitätsklinik Freiburg, Freiburg, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Schultze-Seeman
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 3, Haus 18, 24105, Kiel, Deutschland.
authors.forename: C M
authors.initials: CM
authors.lastname: Naumann
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 3, Haus 18, 24105, Kiel, Deutschland.
authors.forename: M F
authors.initials: MF
authors.lastname: Hamann
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 3, Haus 18, 24105, Kiel, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Bothe
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 3, Haus 18, 24105, Kiel, Deutschland.
authors.forename: K-P
authors.initials: KP
authors.lastname: Jünemann
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome
keywords: Androgen deprivation therapy; Lymph node dissection; Lymph node recurrence; Recurrence, biochemical; Remission, biochemical