Impact Of Previous Whole Pelvis Radiation Therapy In Patients Treated With Salvage Lymph Node Dissection For Prostate Cancer Node-Only Recurrence: Evaluation Of Surgical, Pathological, And Oncological Outcomes

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III (PD34)1 Sep 2021PD34-05 IMPACT OF PREVIOUS WHOLE PELVIS RADIATION THERAPY IN PATIENTS TREATED WITH SALVAGE LYMPH NODE DISSECTION FOR PROSTATE CANCER NODE-ONLY RECURRENCE: EVALUATION OF SURGICAL, PATHOLOGICAL, AND ONCOLOGICAL OUTCOMES Nicola Fossati, Giovanni Motterle, R. Jeffrey Karnes, Armando Stabile, David Pfister, Daniar Osmonov, Klaus-Peter Juenemann, Shahrok Shariat, Bernhard Grubmuller, Alessandro Nini, Andreas Hiester, Peter Albers, Derya Tilki, Markus Graefen, Inderbir S Gill, Axel Heidenreich, Alexander Kretschmer, Alexander Buchner, Christian Stief, Gaëtan Devos, Steven Joniau, Gert De Meerleer, Alexander Mottrie, Andrea Necchi, Francesco Montorsi, and Briganti Alberto Nicola FossatiNicola Fossati More articles by this author , Giovanni MotterleGiovanni Motterle More articles by this author , R. Jeffrey KarnesR. Jeffrey Karnes More articles by this author , Armando StabileArmando Stabile More articles by this author , David PfisterDavid Pfister More articles by this author , Daniar OsmonovDaniar Osmonov More articles by this author , Klaus-Peter JuenemannKlaus-Peter Juenemann More articles by this author , Shahrok ShariatShahrok Shariat More articles by this author , Bernhard GrubmullerBernhard Grubmuller More articles by this author , Alessandro NiniAlessandro Nini More articles by this author , Andreas HiesterAndreas Hiester More articles by this author , Peter AlbersPeter Albers More articles by this author , Derya TilkiDerya Tilki More articles by this author , Markus GraefenMarkus Graefen More articles by this author , Inderbir S GillInderbir S Gill More articles by this author , Axel HeidenreichAxel Heidenreich More articles by this author , Alexander KretschmerAlexander Kretschmer More articles by this author , Alexander BuchnerAlexander Buchner More articles by this author , Christian StiefChristian Stief More articles by this author , Gaëtan DevosGaëtan Devos More articles by this author , Steven JoniauSteven Joniau More articles by this author , Gert De MeerleerGert De Meerleer More articles by this author , Alexander MottrieAlexander Mottrie More articles by this author , Andrea NecchiAndrea Necchi More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Briganti AlbertoBriganti Alberto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002038.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Salvage lymph node dissection (SLND) is considered an experimental treatment for patients with nodal recurrence after radical prostatectomy (RP). However, most of them already received previous adjuvant or salvage whole pelvis radiation therapy (WPRT), which may increase the risk of intra- and post-operative complications, and it may negatively affect the surgical capability to remove pathological nodes, with a detrimental effect on cancer control. We analysed a large series of patients treated with SLND to test the impact of previous WPRT on surgical, pathological, and oncological outcomes. METHODS: We identified 211 patients who received SLND at nine tertiary referral centres. All patients were diagnosed with nodal recurrence after RP by PET/CT scan using either 11C-choline (n=118; 56%) or 68Ga-PSMA (n=93; 44%). Patients were divided into two groups: previous WPRT (Group 1: n=59, 28%) vs no previous WPRT (Group 2: n=152, 72%). The outcomes consisted of: intra- and post-operative complications; rate of negative histology after SLND; biochemical recurrence (BCR, defined as post-SLND PSA level >0.2 ng/ml), and clinical recurrence (CR, defined as positive imaging during follow-up). RESULTS: Patients treated with previous WPRT had a higher rate of pN1 disease after RP (22 vs 14%, p=0.032), and a shorter median time between RP and diagnosis of nodal recurrence (12 vs 28 months, p <0.0001). Conversely, the rate of adjuvant hormonal treatment after RP was similar (44 vs. 42%, p=0.8). The rate of intra- (8.5 vs. 6.6%, p=0.6) and post-operative (31 vs. 27%, p=0.9) complications were not significantly different. Median number of nodes removed (24 vs. 19, p=0.9) and rate of negative histology (15 vs. 11%, p=0.4) did not differ significantly. With a median follow-up of 25 months, 2-yr BCR-free survival was 32 vs. 30% (p=0.5), whereas 2-yr CR-free survival was 61 vs. 62% (p=0.2) (Figure 1). CONCLUSIONS: In this large series of patients treated with SLND, previous WPRT did not significantly affect surgical, pathological, and oncological outcomes. Therefore, it does not represent an exclusion criterion for salvage surgery. These results are relevant for patient treatment, counselling and for future trials design. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e584-e584 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicola Fossati More articles by this author Giovanni Motterle More articles by this author R. Jeffrey Karnes More articles by this author Armando Stabile More articles by this author David Pfister More articles by this author Daniar Osmonov More articles by this author Klaus-Peter Juenemann More articles by this author Shahrok Shariat More articles by this author Bernhard Grubmuller More articles by this author Alessandro Nini More articles by this author Andreas Hiester More articles by this author Peter Albers More articles by this author Derya Tilki More articles by this author Markus Graefen More articles by this author Inderbir S Gill More articles by this author Axel Heidenreich More articles by this author Alexander Kretschmer More articles by this author Alexander Buchner More articles by this author Christian Stief More articles by this author Gaëtan Devos More articles by this author Steven Joniau More articles by this author Gert De Meerleer More articles by this author Alexander Mottrie More articles by this author Andrea Necchi More articles by this author Francesco Montorsi More articles by this author Briganti Alberto More articles by this author Expand All Advertisement Loading ...