Imaging targeted treatments versus extended salvage lymph node dissection for patients with a single nodal recurrence of prostate cancer: A comparative analysis from a large multi-institutional series

INTRODUCTION AND OBJECTIVES:Extended and targeted treatment approaches have been proposed for patients affected by nodal recurrence of prostate cancer (PCa). However, a significant under-estimation of tumour burden by modern imaging has been reported. Therefore, targeted treatments may be associated with sub-optimal cancer control. We aimed at comparing extended salvage lymph node dissection (eSLND) to targeted SLND (tSLND) and targeted stereotactic body radiation therapy (tSBRT) in patients affected by a single nodal recurrence of PCaMETHODS:The study included 567 patients with a single pelvic nodal recurrence of PCa after primary treatment detected by PET/CT scan. Patients were treated with eSLND (Group 1; n=315; 56%), tSLND (Group 2; n=41; 7%), or targeted SBRT (Group 3; n=211; 37%). Extended SLND consisted of bilateral extended pelvic lymph node dissection. On the contrary, targeted treatments were focused only to the treatment of the site of positive PET/CT scan. The outcome consisted of clinical rec...