Adverse Effects and Functional Outcome after Salvage Lymph Node Dissection in Prostate Cancer.

IF 1.4 4区医学 Q3 ONCOLOGY

Oncology Research and Treatment Pub Date : 2026-01-01 Epub Date: 2025-10-23 DOI:10.1159/000549126

Ruth Himmelsbach, Julia Franz, August Sigle, Moritz Weishaar, Larissa Lang, Simon Spohn, Constantinos Zamboglou, Anca-Ligia Grosu, Wolfgang Schultze-Seemann, Christian Gratzke, Markus Grabbert, Cordula Jilg

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引用次数: 0

Abstract

Introduction: The goal of our study was to generate a standardized assessment of postoperative complications and functional results in patients undergoing salvage lymph node dissection (sLND) in a multimodal setting with prior primary therapy and possibly multiple courses of radiation due to nodal-recurrent prostate cancer.

Patients and methods: This study included 173 patients that underwent sLND between 2005 and 2019. Postoperative complications were reported according to Clavien-Dindo-Classification (CDC). Health-related quality of life (QoL) was assessed prospectively using a validated questionnaire (EORTC QLQ-C30). Postoperative urinary incontinence was quantified with the assessment of pad usage and the ICIQ-SF questionnaire.

Results: The any-grade complication rate after sLND was 67% (n = 115 patients). A total of patients (n = 42) had severe postoperative complications (CDC grade ≥IIIa). No grade V complications were reported. The number of lymph nodes removed was higher in patients with any-grade complications (median 32 versus 25, p = 0.03), while the number of lymph node metastases was higher in patients with severe complications (median 7 versus 3, p = 0.03). However, no clinical parameter was independently associated with complications. A total of 56% patients did not require any pads postoperatively. Median postoperative ICIQ-SF score was 5 and was higher in patients with any prior radiation (median 6 versus 0, p = 0.03). Radical prostatectomy as primary therapy (p = 0.01) and any prior radiation (p = 0.01) were independent predictors of any incontinence. Patients' QoL was rated as moderate, with an impairment in QoL in 39% of the follow-up cohort.

Conclusion: SLND is a treatment option in selected patients with nodal-recurrent prostate cancer with considerable complication rates and possible functional impairments that need to be discussed with the patient when balancing the indication for this metastasis-directed treatment option.

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前列腺癌补救性淋巴结清扫术后的不良反应及功能预后。

目的：对淋巴结复发性前列腺癌患者在多模式环境下接受挽救性淋巴结清扫（sLND）的术后并发症和功能结果进行标准化评估，这些患者先前接受过主要治疗，可能接受过多疗程的放疗。患者和方法：本研究包括2005年至2019年期间进行的173例患者。根据clavien - dindo分类（CDC）报告术后并发症。采用有效问卷（EORTC QLQ-C30）对健康相关生活质量（QoL）进行前瞻性评估。术后尿失禁通过尿垫使用评估和ICIQ-SF问卷进行量化。结果：sLND术后任何级别并发症发生率为67% （n=115例）。24%的患者（n=42）出现严重的术后并发症（CDC分级≥IIIa）。无V级并发症报道。任何级别并发症患者的淋巴结切除数量较多（中位数为32比25，p=0.03），而严重并发症患者的淋巴结转移数量较多（中位数为7比3，p=0.03）。然而，没有临床参数与并发症独立相关。56%的患者术后不需要任何衬垫。术后ICIQ-SF评分中位数为5分，有放疗史的患者评分中位数更高（中位数为6比0，p=0.03）。根治性前列腺切除术作为主要治疗（p=0.01）和任何既往放疗（p=0.01）是任何尿失禁的独立预测因素。患者的生活质量被评为中等，39%的随访队列的生活质量受损。结论：SLND是选择性淋巴结复发性前列腺癌患者的一种治疗方案，具有相当高的并发症发生率和可能的功能损害，在平衡这种转移导向治疗方案的适应症时需要与患者讨论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncology Research and Treatment ONCOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

期刊介绍： With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.