The purpose of this study is to determine the effectiveness of salvage lymph node dissection (SLND) for nodal recurrence prostate cancer following initial therapy. In addition, we discuss the diagnostic performance of next-generation sequencing (NGI) radiotracers in the salvage context. The majority of studies examining SLND contain a diverse population with a limited sample size and are designed retrospectively. Prospective studies show that the 5-year clinical recurrence-free and cancer-specific survival rates after SLND are 26–52 percent and 57–89 percent, respectively. When compared to standard CT, NGI improves accuracy in identifying nodal recurrence, with PMSA PET-CT showing the highest potential. However, there have been few studies comparing imaging modalities, and performance is varied at low PSA levels.

SLND is a potential therapeutic approach, however more prospective data is needed to identify the best surgical candidate and long-term oncologic results. More research comparing various NGI is required to find the optimal imaging modality in individuals who may be candidates for salvage therapy.