Salvage-Lymphadenektomie des lymphogenen Prostatakarzinomrezidivs
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Salvage-Lymphadenektomie des lymphogenen Prostatakarzinomrezidivs. / Stolzenbach, Lara Franziska; Knipper, Sophie; Maurer, Tobias.
in: AKTUEL UROL, Jahrgang 51, Nr. 3, 06.2020, S. 258-264.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Salvage-Lymphadenektomie des lymphogenen Prostatakarzinomrezidivs
AU - Stolzenbach, Lara Franziska
AU - Knipper, Sophie
AU - Maurer, Tobias
N1 - © Georg Thieme Verlag KG Stuttgart · New York.
PY - 2020/6
Y1 - 2020/6
N2 - Recent advances in functional imaging, such as prostate-specific membrane antigen positron emission tomography (PSMA PET/CT), provide earlier detection of nodal recurrent prostate cancer. Current studies on metastasis-directed therapy in patients with node-only recurrence suggest a positive influence on the prognosis in selected patients. Nevertheless, most studies are retrospective and, due to a lack of high-level evidence, salvage lymph node dissection (SLND) is not recommended by current guidelines.The aim of this work is to provide a critical summary of the current data on SLND in patients with nodal recurrent prostate cancer with a focus on imaging procedures, extent of SLND and oncological outcome.European guidelines recommend the use of choline or PSMA PET/CT imaging if prostate cancer recurrence is suspected. PSMA PET/CT is superior to choline PET/CT in sensitivity and specificity and should be the preferred approach. Nevertheless, if SLND is performed, common practice is bilateral SLND - even if only unilateral lymph node involvement is detected by PSMA PET/CT. However, unilateral SLND can also be considered. A randomised prospective trial (ProSTone) is being initiated for clarification.PSMA radioguided surgery seems to be a new promising surgical approach. It facilitates the intraoperative detection of lymph node metastases. However, long-term data are still awaited.All in all, SLND achieves a respectable biochemical response rate in carefully selected patients. Nevertheless, prospective studies are necessary in the future in order to define the clinical usefulness more precisely.
AB - Recent advances in functional imaging, such as prostate-specific membrane antigen positron emission tomography (PSMA PET/CT), provide earlier detection of nodal recurrent prostate cancer. Current studies on metastasis-directed therapy in patients with node-only recurrence suggest a positive influence on the prognosis in selected patients. Nevertheless, most studies are retrospective and, due to a lack of high-level evidence, salvage lymph node dissection (SLND) is not recommended by current guidelines.The aim of this work is to provide a critical summary of the current data on SLND in patients with nodal recurrent prostate cancer with a focus on imaging procedures, extent of SLND and oncological outcome.European guidelines recommend the use of choline or PSMA PET/CT imaging if prostate cancer recurrence is suspected. PSMA PET/CT is superior to choline PET/CT in sensitivity and specificity and should be the preferred approach. Nevertheless, if SLND is performed, common practice is bilateral SLND - even if only unilateral lymph node involvement is detected by PSMA PET/CT. However, unilateral SLND can also be considered. A randomised prospective trial (ProSTone) is being initiated for clarification.PSMA radioguided surgery seems to be a new promising surgical approach. It facilitates the intraoperative detection of lymph node metastases. However, long-term data are still awaited.All in all, SLND achieves a respectable biochemical response rate in carefully selected patients. Nevertheless, prospective studies are necessary in the future in order to define the clinical usefulness more precisely.
U2 - 10.1055/a-1132-5180
DO - 10.1055/a-1132-5180
M3 - SCORING: Review
C2 - 32219775
VL - 51
SP - 258
EP - 264
JO - AKTUEL UROL
JF - AKTUEL UROL
SN - 0001-7868
IS - 3
ER -