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Salvage Pelvic Lymph Node Dissection after Radical Prostatectomy for Biochemical and Lymph Node Recurrence
Charlotte Peeters1, Diederik Ponette, Hendrik van Poppel
1Department of Urology, UZ Gasthuisberg, Leuven, Belgium.
Urologia Internationalis
|September 18, 2014
Summary
Salvage pelvic lymphadenectomy successfully treated a challenging nodal recurrence in prostate cancer after radical prostatectomy and radiation. This targeted therapy approach reduced tumor burden, keeping prostate-specific antigen undetectable for five years.
Area of Science:
- Urology
- Oncology
- Nuclear Medicine
Background:
- Prostate cancer is the most common male malignancy.
- Radical prostatectomy and radiation therapy are primary treatments for localized disease.
- Biochemical recurrence, indicated by rising prostate-specific antigen (PSA), occurs in about 40% of post-surgery patients.
Observation:
- A 66-year-old male with persistent undetectable PSA post-prostatectomy and rising PSA after radiotherapy experienced painful mastodynia during anti-androgen therapy.
- (11C) choline PET-CT identified a suspicious enlarged left common iliac lymph node.
- Salvage pelvic lymphadenectomy was performed to address the nodal recurrence.
Findings:
- Post-salvage pelvic lymphadenectomy, the patient's PSA remained undetectable for five years.
- This case demonstrates the successful application of lesion-targeted therapy for oligometastatic disease.
- The procedure significantly reduced tumor burden.
Implications:
- Targeted therapy for oligometastatic prostate cancer may reduce tumor burden and delay disease progression.
- This approach could potentially postpone the need for systemic hormone therapy.
- Salvage surgery offers a viable option for managing challenging nodal recurrences.
