REVIEW  PROSTATE CANCER 

Minerva Chirurgica 2019 February;74(1):97-106

DOI: 10.23736/S0026-4733.18.07796-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Oligometastatic prostate cancer and salvage lymph node dissection: systematic review

Aldo BRASSETTI ✉, Flavia PROIETTI, Vito PANSADORO

Department of Urology, Vincenzo Pansadoro Foundation, Center for Laparoscopic Urology and Medical Oncology, Rome, Italy

INTRODUCTION: We provide a comprehensive description of the physio-pathological theories behind oligometastatic prostate cancer (PCa) and analyze modern imaging techniques, presenting a systematic review of the available evidences regarding salvage lymph node dissection (sLND).
EVIDENCE ACQUISITION: A systematic review was attempted. The PubMed/Medline database was searched for “salvage” AND (“lymph node dissection” OR “lymphadenectomy”) AND “prostate” AND “cancer.” Only English publications were targeted. Relevant original articles addressing the role of sLND in PCa were selected.
EVIDENCE SYNTHESIS: Biochemical response (BR) was reported in 10-79.5% of the cases overall. These results were not durable and biochemical recurrence occurred in 54.5-93.8% of the cases, within 5 years. Furthermore, 50-80% of patients received some kind of adjuvant treatment right after sLND, regardless post-operative prostate-specific antigen levels. Surgery-related morbidity was low, with a 0-27% incidence of Clavien-Dindo III complications. No sLND-related deaths were observed.
CONCLUSIONS: sLND is not associated with a durable response over time but may postpone HT and its related complications, in selected patients. Although a limited morbidity was reported, sLND remains technically demanding and a careful selection of patients is advisable.

KEY WORDS: Oligometastatic cancer - Prostate cancer - Salvage lymph node dissection - Positron emission tomography - Biochemical recurrence