How do you approach isolated recurrence in a para-aortic lymph node following definitive radiation for localized prostate cancer?
Is there a role for salvage LN dissection or salvage RT to the node? And is there a role for systemic therapy (ADT or chemotherapy) in addition? If you recommend RT, how high would you treat the para-aortic nodes?
Answer from: Medical Oncologist at Academic Institution
This is a challenging situation with no data to guide therapy; it is not unreasonable to pursue novel PET imaging (PSMA on trial, fluciclovine) to ensure there is no evidence of other sites of metastatic disease. The treatment of oligometastatic disease continues to evolve. In this situation, I woul...