Adjuvant radiotherapy after salvage lymph node dissection because of nodal relapse of prostate cancer versus salvage lymph node dissection only

Background Nodal pelvic/retroperitoneal recurrent prostate cancer (PCa) after primary therapy can be treated with salvage lymph node dissection (salvage-LND) in order to delay disease progression and offer cure for a subset of patients. Whether adjuvant radiotherapy (ART) in affected regions improve...

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Bibliographic Details
Published in:Strahlentherapie und Onkologie 2015-04, Vol.191 (4), p.310-320
Main Authors: Rischke, Hans Christian, Schultze-Seemann, Wolfgang, Wieser, Gesche, Krönig, Malte, Drendel, Vanessa, Stegmaier, Petra, Krauss, Tobias, Henne, Karl, Volegova-Neher, Natalia, Schlager, Daniel, Kirste, Simon, Grosu, Anca-Ligia, Jilg, Cordula Annette
Format: Article
Language:English
Subjects:
Aged
Combined Modality Therapy - methods
Humans
Lymph Node Excision - methods
Lymphatic Metastasis
Male
Medicine
Medicine & Public Health
Neoplasm Recurrence, Local - diagnosis
Neoplasm Recurrence, Local - prevention & control
Neoplasm Recurrence, Local - radiotherapy
Neoplasm, Residual
Oncology
Original Article
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - therapy
Radiotherapy
Radiotherapy, Adjuvant - methods
Retrospective Studies
Salvage Therapy - methods
Treatment Outcome
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Summary:Background Nodal pelvic/retroperitoneal recurrent prostate cancer (PCa) after primary therapy can be treated with salvage lymph node dissection (salvage-LND) in order to delay disease progression and offer cure for a subset of patients. Whether adjuvant radiotherapy (ART) in affected regions improves the outcome by elimination of residual tumour burden remains unclear. Methods A total of 93 patients with exclusively nodal PCa relapse underwent choline-positron-emission tomography-computed-tomography-directed pelvic/retroperitoneal salvage-LND; 46 patients had surgery only and 47 patients received ART in regions with proven lymph node metastases. In case of subsequent prostate specific antigen (PSA) progression, different imaging modalities were performed to confirm next relapse within or outside the treated region (TR). Mean follow-up was 3.2 years. Results Lymphatic tumour burden was balanced between the two groups. Additional ART resulted in delayed relapse within TR (5-year relapse-free rate 70.7 %) versus surgery only (5-year relapse-free rate 26.3 %, p  
ISSN:0179-7158
1439-099X
DOI:10.1007/s00066-014-0763-5