Skip to main content
main-content

11.05.2018 | Topic Paper | Ausgabe 12/2019

World Journal of Urology 12/2019

Oligorecurrent prostate cancer limited to lymph nodes: getting our ducks in a row

Nodal oligorecurrent prostate cancer

Zeitschrift:
World Journal of Urology > Ausgabe 12/2019
Autoren:
Andrei Fodor, Andrea Lancia, Francesco Ceci, Maria Picchio, Morten Hoyer, Barbara Alicja Jereczek-Fossa, Piet Ost, Paolo Castellucci, Elena Incerti, Nadia Di Muzio, Gianluca Ingrosso

Abstract

Purpose

Oligorecurrent prostate cancer with exclusive nodal involvement represents a common state of disease, amenable to local therapy. New radio-labeled tracers have enriched the possibility of cancer detection and treatment. In this review, we aim to illustrate the main nuclear medicine diagnostic options and the role of radiotherapy in this setting of patients.

Methods

We performed a PubMed search referring to the PRISMA guidelines to analyze the performance of PSMA- and choline-PET in detecting oligorecurrence limited to lymph nodes, and to review the main studies supporting either ablative stereotactic body radiotherapy or regional lymph node irradiation in this clinical setting.

Results

PSMA-PET has shown higher efficacy in the diagnosis of nodal lesions if compared with choline-PET. More specifically, for PSA ≤ 2 ng/ml, the median detection rate of choline-PET ranges from 19.5 to 44.5%, whereas PSMA ranges from 51.5 to 74%. SBRT achieves high local control rates positively affecting progression-free survival (PFS), with androgen deprivation therapy (ADT)-free survival ranging from 25 to 44 months and with low toxicity rates (0–15%). Prophylactic nodal irradiation shows 3-year PFS rates ranging from 62 to 75%, but with a potential higher risk of toxicity. However, the chosen treatment option needs to be tailored on the single patient.

Conclusions

Newer PET/CT radio-labeled tracers have increased disease detection in oligorecurrent prostate cancer patients. Growing evidence of their impact on metastasis-directed therapy encourages the use of the most advanced radiotherapy techniques in the clinical management of such patients.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 12/2019

World Journal of Urology 12/2019 Zur Ausgabe
  1. Sie können e.Med Gynäkologie & Urologie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Urologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Urologie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise