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Advances in Urology
Volume 2014 (2014), Article ID 321619, 8 pages
http://dx.doi.org/10.1155/2014/321619
Research Article

Extended Salvage Pelvic Lymph Node Dissection in Patients with Recurrent Prostate Cancer

Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straβe 7, 24105 Kiel, Germany

Received 12 June 2013; Revised 18 December 2013; Accepted 18 December 2013; Published 12 February 2014

Academic Editor: Axel S. Merseburger

Copyright © 2014 Daniar K. Osmonov et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Treatment of patients with a biochemical recurrence (BCR) of prostate cancer (PCa) is generally difficult and without valid treatment options. Since 2004 we have been developing therapeutic possibilities for these patients. Methods. We retrospectively analyzed a cohort of 41 patients with a BCR of PCa and a mean followup of months. Group 1 ( ): salvage radical prostatectomy (sRP) with SePLND (salvage extended pelvic lymph nodes dissection) (initial treatment: combined brachytherapy). Group 2 ( ): SePLND (initial treatment: radical prostatectomy (RP)). Group 3 ( ): SePLND (initial treatment: RP and adjuvant radiation therapy (RT)). We observed PSA, PSA-velocity, localization of LNs and LNs+, BCR-free period, and BR (biochemical response). Results. Group 1: 60% with BCR-freedom (mean 27.2 months). Group 2: 63.6% with BCR-freedom (mean 17.5 months). Group 3: 33.3% with BCR-freedom (mean 17.6 months). In total, BCR-freedom was observed in 23 of 41 patients (56.1%) after salvage surgery. 75.6% of all patients showed a BR. 765 LNs were removed and 14.8% of these were LN+. Conclusions. The BCR-free period and BR are comparable in all three groups. Sensibility to ADT can be reestablished and prolonged as a result of SePLND. Multicenter studies are needed for a reliable output.