Would you treat pelvic lymph nodes in your salvage prostate patient after RP without adverse features due to a limited/no pelvic lymph node sampling?
For the purpose of this question, please assume an initially undetectable post-prostatectomy PSA, no presence of positive margins, extracapsular extension, nor seminal vesicle invasion, and two or fewer pelvic lymph nodes sampled at time of surgery.
Answer from: Radiation Oncologist at Academic Institution
No, not based on lack of extended PLND, alone.RADICALS left lymph node coverage to physician discretion, and only 3% of salvage patients received pelvic lymph node irradiation. 44% of the patients on RADICALS had no lymph node dissection. Strongest evidence in favor is SPPORT, with biochemical ...
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