Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Department of Radiology, Division of Molecular Imaging and Therapeutics (Mit), University of North Carolina, Chapel Hill, NC, USA.
Curr Urol Rep. 2020 Nov 7;21(12):62. doi: 10.1007/s11934-020-01011-z.
We aim to evaluate the efficacy of salvage lymph node dissection (SLND) for nodal recurrent prostate cancer after primary treatment. We also provide a review of the diagnostic performance of next-generation sequencing (next-generation imaging (NGI)) radiotracers in the salvage setting.
Most studies evaluating SLND include a heterogeneous population with a small sample size and are retrospective in design. The 5-year clinical recurrence-free and cancer-specific survival following SLND are 26-52% and 57-89%, respectively, among prospective studies. NGI improves accuracy in detecting nodal recurrence compared to conventional CT, with PMSA PET-CT showing the most promise. However, limited studies exist comparing imaging modalities and performance is variable at low PSA values. SLND is a promising treatment option, but more prospective data are needed to determine the ideal surgical candidate and long-term oncologic outcomes. More studies comparing different NGI are needed to determine the best imaging modality in patients who may be candidates for salvage treatment.
本研究旨在评估在初次治疗后对淋巴结复发性前列腺癌进行挽救性淋巴结清扫术（SLND）的疗效。我们还对下一代测序（下一代成像（NGI））放射性示踪剂在挽救性治疗中的诊断性能进行了综述。
大多数评估 SLND 的研究都包含一个异质性人群，样本量较小，且设计为回顾性。前瞻性研究显示，SLND 后 5 年的临床无复发生存率和癌症特异性生存率分别为 26-52%和 57-89%。与传统 CT 相比，NGI 提高了检测淋巴结复发的准确性，其中 PMSA PET-CT 显示出最有前途的结果。然而，比较成像方式的研究有限，并且在 PSA 值较低时性能存在差异。SLND 是一种有前途的治疗选择，但需要更多的前瞻性数据来确定理想的手术候选者和长期肿瘤学结果。需要更多比较不同 NGI 的研究来确定在可能适合挽救性治疗的患者中最佳的成像方式。
