Oligometastatic prostate cancer and salvage lymph node dissection: systematic review.

Abstract:

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.

journal_name

Minerva Chir

journal_title

Minerva chirurgica

authors

Brassetti A,Proietti F,Pansadoro V

doi

10.23736/S0026-4733.18.07796-9

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

97-106

issue

1

eissn

0026-4733

issn

1827-1626

pii

S0026-4733.18.07796-9

journal_volume

74

pub_type

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