- Approximately 25% of patients with prostate cancer who undergo salvage lymph node dissection (SLND) for nodal recurrence after local treatment experience early clinical recurrence (eCR; ≤1 year).
- A risk stratification tool based on preoperative characteristics can identify optimal candidates for SLND.
Why this matters
- This tool can help avoid SLND in men likely to progress despite any imaging-guided approach.
- 654 patients with prostate cancer underwent SLND after experiencing PSA rise and nodal recurrence after radical prostatectomy.
- Funding: None.
- Median follow-up was 30 months in patients without eCR.
- 334 patients developed eCR.
- Probability of eCR was 25%.
- 3-year mortality rates were significantly higher in patients with eCR vs those without (20% vs 1.4%; P<.0001>
- Significant predictors for eCR used for the model were:
- Gleason grade group 5 (HR, 2.04; P<.0001>
- time from surgery to PSA rising (HR, 0.99; P=.025),
- hormonal therapy at PSA rise (HR, 1.47; P=.0005),
- retroperitoneal uptake at positron emission tomography/computed tomography (PET/CT) scan (HR, 1.24; P=.038),
- ≥3 positive spots at PET/CT scan (HR, 1.26; P=.019), and
- PSA level at SLND (HR, 1.05; P<.0001>
- Retrospective design.