Abstract
Background: The management of patients with clinical recurrence of prostate cancer after radical prostatectomy (RP) remains challenging. Objective: To determine whether the removal of positive lymph nodes at [11C]choline positron emission tomography/computed tomography (PET/CT) scan may have an impact on the prognosis of patients with biochemical recurrence (BCR) and nodal recurrence after RP. Design, setting, and participants: Prospective analysis of 72 patients affected by BCR after RP associated with a nodal pathologic [11C]choline PET/CT scan. Intervention: Patients underwent salvage lymph node dissection (LND). Measurements: Biochemical response (BR) to treatment was defined as prostate-specific antigen (PSA) 4 ng/ml (HR: 2.13; p = 0.03) and the presence of retroperitoneal uptake at PET/CT scan (HR = 2.92; p = 0.004) represented independent preoperative predictors of CR. Similarly, the presence of pathologic nodes in the retroperitoneum (HR: 2.78; p = 0.02), higher number of positive lymph nodes (HR: 1.04; p = 0.006), and complete BR to salvage LND (HR: 0.31; p = 0.002) represented postoperative independent predictors of CR. Main limitations consisted of the lack of a control group and the heterogeneity of patients included in the analyses. Conclusions: Salvage LND is feasible in patients with BCR after RP and nodal pathologic uptake at [11C]choline PET/CT scan. Biochemical response after surgery can be achieved in a consistent proportion of patients. Although most patients invariably progressed to BCR after surgery at longer follow-up, 35% of patients showed the absence of CR at 5 yr.
Original language | English |
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Pages (from-to) | 935-943 |
Number of pages | 9 |
Journal | European Urology |
Volume | 60 |
Issue number | 5 |
DOIs | |
Publication status | Published - Nov 2011 |
Keywords
- [11C]choline PET/CT
- Biochemical recurrence
- Lymph node dissection
- Prostate cancer
ASJC Scopus subject areas
- Urology