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Safety and efficiency of repeat salvage lymph node dissection for recurrence of prostate cancer using PSMA-radioguided surgery (RGS) after prior salvage lymph node dissection with or without initial RGS support

Standard

Safety and efficiency of repeat salvage lymph node dissection for recurrence of prostate cancer using PSMA-radioguided surgery (RGS) after prior salvage lymph node dissection with or without initial RGS support. / Falkenbach, Fabian; Knipper, Sophie; Koehler, Daniel; Ambrosini, Francesca; Steuber, Thomas; Graefen, Markus; Budäus, Lars; Eiber, Matthias; Lunger, Lukas; Lischewski, Flemming; Heck, Matthias M; Maurer, Tobias.

in: WORLD J UROL, Jahrgang 41, Nr. 9, 09.2023, S. 2343-2350.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Falkenbach, F, Knipper, S, Koehler, D, Ambrosini, F, Steuber, T, Graefen, M, Budäus, L, Eiber, M, Lunger, L, Lischewski, F, Heck, MM & Maurer, T 2023, 'Safety and efficiency of repeat salvage lymph node dissection for recurrence of prostate cancer using PSMA-radioguided surgery (RGS) after prior salvage lymph node dissection with or without initial RGS support', WORLD J UROL, Jg. 41, Nr. 9, S. 2343-2350. https://doi.org/10.1007/s00345-023-04534-5

APA

Falkenbach, F., Knipper, S., Koehler, D., Ambrosini, F., Steuber, T., Graefen, M., Budäus, L., Eiber, M., Lunger, L., Lischewski, F., Heck, M. M., & Maurer, T. (2023). Safety and efficiency of repeat salvage lymph node dissection for recurrence of prostate cancer using PSMA-radioguided surgery (RGS) after prior salvage lymph node dissection with or without initial RGS support. WORLD J UROL, 41(9), 2343-2350. https://doi.org/10.1007/s00345-023-04534-5

Vancouver

Falkenbach F, Knipper S, Koehler D, Ambrosini F, Steuber T, Graefen M et al. Safety and efficiency of repeat salvage lymph node dissection for recurrence of prostate cancer using PSMA-radioguided surgery (RGS) after prior salvage lymph node dissection with or without initial RGS support. WORLD J UROL. 2023 Sep;41(9):2343-2350. https://doi.org/10.1007/s00345-023-04534-5

Bibtex

@article{dd50f97c606447e797aebf1292db6021,
title = "Safety and efficiency of repeat salvage lymph node dissection for recurrence of prostate cancer using PSMA-radioguided surgery (RGS) after prior salvage lymph node dissection with or without initial RGS support",
abstract = "BACKGROUND AND OBJECTIVE: Metastasis-directed therapy is a feasible option for low PSA, recurrent locoregional metastatic prostate cancer. After initial salvage surgery, patients with good response might consider a repeat salvage surgery in case of recurrent, isolated, and PSMA-positive metastases. This analysis aimed to evaluate the oncological outcome and safety of repeat PSMA-targeted radioguided surgery (RGS) after either prior RGS or {"}standard{"} salvage lymph node dissection (SLND).MATERIALS AND METHODS: We identified 37 patients undergoing repeat RGS after prior SLND (n = 21) (SLND-RGS) or prior RGS (n = 16) (RGS-RGS) between 2014 and 2021 after initial radical prostatectomy with or without pelvic radiation therapy at two German tertiary referral centers. Kaplan-Meier analyses and uni-/multivariable Cox regression models were used to investigate factors associated with biochemical recurrence-free survival (BRFS) and treatment-free survival (TFS) after repeat salvage surgery.RESULTS AND LIMITATIONS: Complete Biochemical Response (cBR, PSA < 0.2 ng/ml) was observed in 20/32 patients (5 NA). Median overall BRFS [95% confidence interval (CI)] after repeat salvage surgery was 10.8 months (mo) (5.3-22). On multivariable regression, only age (HR 1.09, 95% CI 1.01-1.17) and preoperative PSA (HR 1.23, 95% CI 1.01-1.50) were associated with shorter BRFS, although PSA (HR 1.16, 95% CI 0.99-1.36) did not achieve significant predictor status in univariable analysis before (p value = 0.07). Overall, one year after second salvage surgery, 89% of the patients (number at risk: 19) did not receive additional treatment and median TFS was not reached. Clavien-Dindo grade > 3a complications were observed in 8% (3/37 patients). Limitations are the retrospective evaluation, heterogeneous SLND procedures, lack of long-term follow-up data, and small cohort size.CONCLUSION: In this study, repeat RGS was safe and provided clinically meaningful biochemical recurrence- and treatment-free intervals for selected cases. Patients having low preoperative PSA seemed to benefit most of repeat RGS, irrespective of prior SLND or RGS or the time from initial RP/first salvage surgery.",
keywords = "Male, Humans, Prostate-Specific Antigen, Retrospective Studies, Neoplasm Recurrence, Local/surgery, Lymph Node Excision/methods, Prostatic Neoplasms/surgery, Surgery, Computer-Assisted/methods, Salvage Therapy/methods, Prostatectomy/methods",
author = "Fabian Falkenbach and Sophie Knipper and Daniel Koehler and Francesca Ambrosini and Thomas Steuber and Markus Graefen and Lars Bud{\"a}us and Matthias Eiber and Lukas Lunger and Flemming Lischewski and Heck, {Matthias M} and Tobias Maurer",
note = "{\textcopyright} 2023. The Author(s).",
year = "2023",
month = sep,
doi = "10.1007/s00345-023-04534-5",
language = "English",
volume = "41",
pages = "2343--2350",
journal = "WORLD J UROL",
issn = "0724-4983",
publisher = "Springer",
number = "9",

}

RIS

TY - JOUR

T1 - Safety and efficiency of repeat salvage lymph node dissection for recurrence of prostate cancer using PSMA-radioguided surgery (RGS) after prior salvage lymph node dissection with or without initial RGS support

AU - Falkenbach, Fabian

AU - Knipper, Sophie

AU - Koehler, Daniel

AU - Ambrosini, Francesca

AU - Steuber, Thomas

AU - Graefen, Markus

AU - Budäus, Lars

AU - Eiber, Matthias

AU - Lunger, Lukas

AU - Lischewski, Flemming

AU - Heck, Matthias M

AU - Maurer, Tobias

N1 - © 2023. The Author(s).

PY - 2023/9

Y1 - 2023/9

N2 - BACKGROUND AND OBJECTIVE: Metastasis-directed therapy is a feasible option for low PSA, recurrent locoregional metastatic prostate cancer. After initial salvage surgery, patients with good response might consider a repeat salvage surgery in case of recurrent, isolated, and PSMA-positive metastases. This analysis aimed to evaluate the oncological outcome and safety of repeat PSMA-targeted radioguided surgery (RGS) after either prior RGS or "standard" salvage lymph node dissection (SLND).MATERIALS AND METHODS: We identified 37 patients undergoing repeat RGS after prior SLND (n = 21) (SLND-RGS) or prior RGS (n = 16) (RGS-RGS) between 2014 and 2021 after initial radical prostatectomy with or without pelvic radiation therapy at two German tertiary referral centers. Kaplan-Meier analyses and uni-/multivariable Cox regression models were used to investigate factors associated with biochemical recurrence-free survival (BRFS) and treatment-free survival (TFS) after repeat salvage surgery.RESULTS AND LIMITATIONS: Complete Biochemical Response (cBR, PSA < 0.2 ng/ml) was observed in 20/32 patients (5 NA). Median overall BRFS [95% confidence interval (CI)] after repeat salvage surgery was 10.8 months (mo) (5.3-22). On multivariable regression, only age (HR 1.09, 95% CI 1.01-1.17) and preoperative PSA (HR 1.23, 95% CI 1.01-1.50) were associated with shorter BRFS, although PSA (HR 1.16, 95% CI 0.99-1.36) did not achieve significant predictor status in univariable analysis before (p value = 0.07). Overall, one year after second salvage surgery, 89% of the patients (number at risk: 19) did not receive additional treatment and median TFS was not reached. Clavien-Dindo grade > 3a complications were observed in 8% (3/37 patients). Limitations are the retrospective evaluation, heterogeneous SLND procedures, lack of long-term follow-up data, and small cohort size.CONCLUSION: In this study, repeat RGS was safe and provided clinically meaningful biochemical recurrence- and treatment-free intervals for selected cases. Patients having low preoperative PSA seemed to benefit most of repeat RGS, irrespective of prior SLND or RGS or the time from initial RP/first salvage surgery.

AB - BACKGROUND AND OBJECTIVE: Metastasis-directed therapy is a feasible option for low PSA, recurrent locoregional metastatic prostate cancer. After initial salvage surgery, patients with good response might consider a repeat salvage surgery in case of recurrent, isolated, and PSMA-positive metastases. This analysis aimed to evaluate the oncological outcome and safety of repeat PSMA-targeted radioguided surgery (RGS) after either prior RGS or "standard" salvage lymph node dissection (SLND).MATERIALS AND METHODS: We identified 37 patients undergoing repeat RGS after prior SLND (n = 21) (SLND-RGS) or prior RGS (n = 16) (RGS-RGS) between 2014 and 2021 after initial radical prostatectomy with or without pelvic radiation therapy at two German tertiary referral centers. Kaplan-Meier analyses and uni-/multivariable Cox regression models were used to investigate factors associated with biochemical recurrence-free survival (BRFS) and treatment-free survival (TFS) after repeat salvage surgery.RESULTS AND LIMITATIONS: Complete Biochemical Response (cBR, PSA < 0.2 ng/ml) was observed in 20/32 patients (5 NA). Median overall BRFS [95% confidence interval (CI)] after repeat salvage surgery was 10.8 months (mo) (5.3-22). On multivariable regression, only age (HR 1.09, 95% CI 1.01-1.17) and preoperative PSA (HR 1.23, 95% CI 1.01-1.50) were associated with shorter BRFS, although PSA (HR 1.16, 95% CI 0.99-1.36) did not achieve significant predictor status in univariable analysis before (p value = 0.07). Overall, one year after second salvage surgery, 89% of the patients (number at risk: 19) did not receive additional treatment and median TFS was not reached. Clavien-Dindo grade > 3a complications were observed in 8% (3/37 patients). Limitations are the retrospective evaluation, heterogeneous SLND procedures, lack of long-term follow-up data, and small cohort size.CONCLUSION: In this study, repeat RGS was safe and provided clinically meaningful biochemical recurrence- and treatment-free intervals for selected cases. Patients having low preoperative PSA seemed to benefit most of repeat RGS, irrespective of prior SLND or RGS or the time from initial RP/first salvage surgery.

KW - Male

KW - Humans

KW - Prostate-Specific Antigen

KW - Retrospective Studies

KW - Neoplasm Recurrence, Local/surgery

KW - Lymph Node Excision/methods

KW - Prostatic Neoplasms/surgery

KW - Surgery, Computer-Assisted/methods

KW - Salvage Therapy/methods

KW - Prostatectomy/methods

U2 - 10.1007/s00345-023-04534-5

DO - 10.1007/s00345-023-04534-5

M3 - SCORING: Journal article

C2 - 37515651

VL - 41

SP - 2343

EP - 2350

JO - WORLD J UROL

JF - WORLD J UROL

SN - 0724-4983

IS - 9

ER -