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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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2/2021
vol. 16
 
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abstract:
Original paper

18F-choline positron emission tomography/computed tomography guided laparoscopic salvage lymph node dissection in patients after radical prostatectomy

Markiian Kubis
1
,
Krystian Kaczmarek
1
,
Artur Lemiński
1
,
Marcin Słojewski
1

  1. Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland
Videosurgery Miniinv 2021; 16 (2): 403–408
DOI: https://doi.org/10.5114/wiitm.2020.100738
Online publish date: 2020/11/13
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Introduction
Salvage lymph node dissection (sLND) using novel imaging methods is an interesting alternative to treat lymph node (LN) metastasis after radical prostatectomy (RP); however, recommendations for using sLND as such are still being developed.

Aim
To assess the clinical outcomes of prostate cancer (PCa) after fluorine-18-choline (18F-choline) positron emission tomography/computed tomography (PET/CT) guided sLND.

Material and methods
Ten patients who had undergone sLND under 18F-choline PET/CT guidance (positive nodes: median 1, range 1-3) and had biochemical recurrence or persistence of prostate-specific antigen (PSA: median PSA 2.05 ng/ml, range: 0.8–8.4) after RP were enrolled in this retrospective study. Complete biochemical response (cBCR) after salvage surgery was defined as PSA < 0.2 ng/ml.

Results
The median follow-up time after salvage surgery was 33 months. The median PSA level 6 weeks after sLND and at the end of follow-up was 0.93 and 2.95 ng/ml, respectively. At 6 weeks after targeted sLND only 1 patient had cBCR, whereas a PSA decrease was noted in 7 patients. No patient had cBCR at the end of follow-up.

Conclusions
Laparoscopic sLND in cases of LN metastatic PCa after RP is a feasible option with low morbidity. However, an initial cBCR occurs in a negligible proportion of patients, and a long-term response is unlikely to be achieved.

keywords:

prostate cancer, radical prostatectomy, choline, salvage lymph node dissection, fluorine-18
  
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