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The Journal of the Brazilian Society of Cancerology

Robot-assisted salvage lymphadenectomy in prostatecancer with radiointerventional lymph node tagging

Yza Mariana Conceição Brito
Nilo Cesar Leao Barreto de Souza
Nilo Jorge Carvalho Leao Barretto
Leonardo Marques Calazans

Summary: Prostate cancer is the second most common tumor in men worldwide, with lethality directly related to its staging. In general, radical prostatectomy represents the first line in the treatment of patients with prostate cancer, but even with improvements in diagnosis and advances in surgical techniques for the treatment of localized prostate cancer, it still occurs in up to 35% of cases. there will be biochemical recurrence over the years¹. Therefore, when this neoplasm recurs after the primary approach,
treatment may vary according to its location and dissemination pattern. In cases of lymph node recurrence, adjunctive treatment with external radiotherapy is routinely indicated, associated or not with hormonal blockade.² However, in recent years, due to the advent of new imaging modalities with high sensitivity in cases of biochemical recurrence, the use of salvage lymphadenectomy has been proposed.² Thus, robotic salvage lymphadenectomy has emerged as an alternative to the treatment of patients with lymph node recurrence of prostate cancer. In this way, we seek to share, through a case report, the surgical technique of rescue lymphadenectomy with a lymph node marked by radiointervention. There are no conflicts of interest in this report.

Keywords: Prostate Neoplasms. Lymphatic Metastasis. PET-PMSA . Robotic Surgical Procedures. Lymph node marking by radiointervention .

Abstract: Prostate cancer is the second most common tumor in men worldwide, with lethality directly related to its staging. In general, radical prostatectomy represents the first line in the treatment of patients with prostate cancer, but even with improvements in diagnosis and advances in surgical techniques for the treatment of localized prostate cancer, it still occurs in up to 35% of cases. there will be biochemical recurrence over the years¹. Therefore, when this neoplasm recurs after the primary approach,
treatment may vary according to its location and dissemination pattern. In cases of lymph node recurrence, adjunctive treatment with external radiotherapy is routinely indicated, associated or not with hormonal blockade.² However, in recent years, due to the advent of new imaging modalities with high sensitivity in cases of biochemical recurrence, the use of Rescue lymphadenectomy has been proposed.² Thus, robotic rescue lymphadenectomy has emerged as an alternative to the treatment of patients with lymph node recurrence of prostate cancer. In this way, we seek to share, through a case report, the surgical technique of rescue lymphadenectomy with a lymph node marked by radiointervention. There are no conflicts of interest in this report.

Keywords: Prostate Neoplasms. Lymphatic Metastasis. PET-PMSA. Robotic Surgical Procedures. Lymph node marking by radiointervention.

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