Extended pelvic lymph-node dissection and radiotherapy with curative intent in high-risk lymph-node-positive prostate cancer: a possible curative strategy?

AbstractObjective: This study evaluated the outcome with a treatment strategy for high-risk prostate cancer (PCa) using extended pelvic lymph-node dissection (eLND) followed by external beam radiation therapy (EBRT) in lymph-node-positive (LNpos) and lymph-node-negative (LNneg) cases compared with the strategy with limited pelvic lymph-node dissection (lLND) and only giving EBRT to LNneg cases.Materials and methods: From 2000 to 2006, 124 men with high-risk PCa underwent lLND and initiated androgen deprivation therapy (ADT) before planned EBRT. LNpos patients were excluded from EBRT following the SPCG-7 study strategy (group I). From 2007 to 2013, 111 patients underwent eLND and started ADT before EBRT, and LNneg and most LNpos patients received EBRT (group II). Using Kaplan–Meier plots and multivariable Cox regression, biochemical recurrence-free, metastasis-free, cancer-specific survival and overall survival were compared during a 10 year follow-up.Results: PSA progression-free survival rates after 2, 4...