Assessing the Best Surgical Template at Salvage Pelvic Lymph Node Dissection for Nodal Recurrence of Prostate Cancer After Radical Prostatectomy: When Can Bilateral Dissection be Omitted? Results from a Multi-institutional Series

In patients with a positron emission tomography (PET) scan suggestive of unilateral nodal recurrence from prostate cancer (PCa) after radical prostatectomy, a bilateral salvage lymph node dissection demonstrated a contralateral disease missed by imaging in approximately one of five patients. This rate varied according to the number of positive spots and PET tracer, with the lowest rate of missed PCa in men diagnosed with a single positive spot at 68Ga prostate-specific membrane antigen PET scan (6%). If replicated, our data suggest that these patients might be considered for unilateral extended pelvic salvage lymph node dissection when correct staging is considered as an endpoint.