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How would you manage a patient with localized prostate cancer treated with radical prostatectomy and found to have a single involved pelvic lymph node on final pathology and a detectable postoperative PSA?

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How would you manage a patient with localized prostate cancer treated with radical prostatectomy, pN1 on final pathology with detectable postoperative PSA?

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2 Answers
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Medical Oncology · Duke University School of Medicine
Answered on

This patient is now in the salvage setting with PSA recurrence after RP and with PSA persistence and node-positive disease. This is a grey area of medicine without level 1 evidence from RCTs but there are some sources of data to help guide optimal outcomes. This patient is at high risk for further m...

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Radiation Oncology · Case Western Reserve University/ University Hospitals Seidman Cancer Center
Answered on

I largely agree with @Dr. First Last. This is an area more data is needed.

Fortunately, the open and enrolling NRG GU008 is one of the few trials specifically aimed at determining the optimal treatment for pN+ patients post-RP with BCR.

The control arm is salvage RT + 2 years of ADT.

Experimental arm i...

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