The following is a summary of “Oncologic outcomes of patients with lymph node invasion at prostatectomy and post-prostatectomy biochemical persistence,” published in the February 2023 issue of Urologic Oncology by Perera et al.

Having your prostate-specific antigen (PSA) remain abnormally high after a prostatectomy indicates that cancer spread to the lymph nodes during the procedure. Care plans for these patients are not well-defined. The primary objective of the research was to examine oncologic survival rates and patterns of illness development over a long period. The study included men treated between 2000-2017 with lymph node invasion after radical prostatectomy and persistently detectable PSA after prostatectomy. It was decided to compile imaging post-op procedures and treatment plans. Overall survival (OS), prostate cancer-specific survival (PCSS), and patterns of recurrence-free survival were evaluated.

Among their original group of 253, around 126 experienced metastases. Of the 25 patients who had a scan that showed cancer within 6 months of surgery, 15 (60%) had metastases in their lymph nodes, 10 (40%) had metastases in their bones, and 4 (16%) had a local recurrence. The 5-year probability of survival without metastases was 52% (95% CI 45%, 58%), whereas the 10-year probability was 37% (95% CI 28%, 46%). The 5-year probability of survival from prostate cancer was 89% (95% CI 84%, 93%), and the 10-year probability was 67% (95% CI 57%, 76%). A total of 221 people went on to get only hormonal deprivation treatment. Ten patients were treated with radiation after surgery.

Patients with lymph node invasion who show biochemical persistence have an increased risk of disease progression and shorter prostate cancer-specific survival. The inability of available imaging techniques to precisely detect the residual disease during the study period hampered effective management. Innovative molecular imaging has the potential to enhance staging and aid in the development of a therapeutic approach that is tailored to the individual needs of each patient.

Source: sciencedirect.com/science/article/abs/pii/S1078143922004033