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ABSTRACT: Introduction
The role of salvage lymph node dissection (SLND) and radiotherapy (SLNRT) in the management of nodal-only recurrent prostate cancer (PC) remains controversial. In addition, impact on health-related quality of life (HRQOL) has not been adequately evaluated yet.Materials and methods
Analysis was limited to patients that were diagnosed with nodal-only recurrent PC via PSMA-PET/CT. SLND was performed via open approach. For SLNRT, dose regimens were normo- or slightly hypo-fractionated with a simultaneous boost to the PET-positive recurrences. EORTC QLQ-C30 and PR-25 questionnaires were used to assess HRQOL. Continence status was assessed using daily pad usage and the validated ICIQ-SF questionnaire. For multivariable analysis, Cox regression models were used (p<0.05).Results
138 patients (SLND: 71; SLNRT: 67) were included in the retrospective analysis. Median follow-up was 47 months (mo) for SLNRT patients (IQR 40-61), and 33mo for SLND patients (IQR 20-49; p<0.001). In total, 61 patients (91.0%) in the SLNRT cohort and 43 patients (65.2%; p<0.001) in the SLND cohort underwent ADT anytime during the follow-up period. In multivariate Cox regression analysis, SLNRT could be confirmed as an independent predictor for increased PSA progression-free survival (PFS; HR 0.08, 95%CI 0.040 - 0.142, p<0.001). Estimated median metastasis-free survival (MFS) was 70mo for the total cohort without statistically significant differences between both subgroups (p=0.216). There were no significant differences regarding general HRQOL, daily pad usage, and ICIQ-SF scores between the respective cohorts.Conclusions
In a large contemporary series of patients with nodal-only recurrent PC based on PSMA-PET/CT staging, we observed significantly increased PSA PFS in patients undergoing SLNRT while no significant differences could be observed in MFS, and functional outcomes including HRQOL.
SUBMITTER: Kretschmer A
PROVIDER: S-EPMC8255992 | biostudies-literature | 2021
REPOSITORIES: biostudies-literature
Kretschmer Alexander A Milow Johanna J Eze Chukwuka C Buchner Alexander A Li Minglun M Westhofen Thilo T Fuchs Frederik F Rogowski Paul P Trapp Christian C Ganswindt Ute U Zacherl Mathias Johannes MJ Beyer Leonie L Wenter Vera V Bartenstein Peter P Schlenker Boris B Stief Christian G CG Belka Claus C Schmidt-Hegemann Nina-Sophie NS
Frontiers in oncology 20210621
<h4>Introduction</h4>The role of salvage lymph node dissection (SLND) and radiotherapy (SLNRT) in the management of nodal-only recurrent prostate cancer (PC) remains controversial. In addition, impact on health-related quality of life (HRQOL) has not been adequately evaluated yet.<h4>Materials and methods</h4>Analysis was limited to patients that were diagnosed with nodal-only recurrent PC <i>via</i> PSMA-PET/CT. SLND was performed <i>via</i> open approach. For SLNRT, dose regimens were normo- o ...[more]