Oligometastatic prostate cancer and salvage lymph node dissection: systematic review

Area of Science:

• Urology
• Oncology
• Surgical Oncology

Background:

• Oligometastatic prostate cancer (PCa) presents unique physio-pathological challenges.
• Modern imaging techniques are evolving for PCa management.
• Salvage lymph node dissection (sLND) is an emerging treatment modality.

Purpose of the Study:

• To systematically review the evidence for salvage lymph node dissection (sLND) in prostate cancer (PCa).
• To analyze the efficacy and safety of sLND in managing PCa.
• To describe the physio-pathological basis and imaging for oligometastatic PCa.

Main Methods:

• A systematic literature search was conducted on PubMed/Medline.
• Keywords included "salvage," "lymph node dissection/lymphadenectomy," "prostate," and "cancer."
• English-language publications relevant to sLND in PCa were selected.

Main Results:

• Biochemical response rates ranged from 10-79.5%, but biochemical recurrence occurred in 54.5-93.8% within 5 years.
• 50-80% of patients received adjuvant treatment post-sLND, irrespective of PSA levels.
• Surgery-related morbidity was low (0-27% Clavien-Dindo III complications), with no observed deaths.

Conclusions:

• sLND does not provide a durable response but may delay hormone therapy (HT) in selected PCa patients.
• Despite low reported morbidity, sLND is technically challenging.
• Careful patient selection is essential for successful sLND outcomes in PCa.