Salvage Lymphadenectomy as a Treatment of Prostate Cancer Recurrence

Biochemical recurrence (BCR) occurs up to 40% of men who had radical prostatectomy for localized prostate cancer. Regional nodes are usually involved in these cases. Salvage lymphadenectomy (sLND) has been advocated in patients with 'node-only' metastasis with biochemical recurrence, following a definitive treatment of primary prostate cancer. In general, limited case number was reported for each previous study. Four relatively larger reports so far with the highest case number of 189. One randomized controlled study has been completed so far at Phase II level. Salvage LND seems to be safe with relatively low incidence of complications without perioperative mortality. It may postpone adjuvant therapy in selected cases, avoiding systemic side effects and possibly reducing the cost. However, long-term outcome is not very encouraging.