Evidence map›Paper›PMID 40654037›Full record

ReviewCurrent opinion in urology2025

The role of radiotherapy in pelvic nodal recurrence following definitive treatment for prostate cancer.

Alessandro Dematteis, Marcin Miszczyk, Angelo Cormio, Akihiro Matsukawa, Paolo Gontero, Shahrokh F Shariat

Abstract readReview
In one paragraph

Review in Current opinion in urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alessandro DematteisDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Marcin MiszczykDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Angelo CormioDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Akihiro MatsukawaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Paolo GonteroDivision of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza at Molinette Hospital and University of Turin, Turin, Italy.
Shahrokh F ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewTo summarize recent evidence on the role of radiotherapy in managing pelvic lymph node (PLN) recurrence following curative-intent primary therapy for prostate cancer (PCa), focusing on radiotherapy strategies, novel medical imaging, and oncological outcomes. RECENT

findingsProstate-specific membrane antigen PET (PSMA-PET) has improved accuracy of staging in patients with PCa; however, more often than not, it fails to correctly identify PLN metastases, and the impact on clinical outcomes of the patients is uncertain. Metastasis-directed therapies (MDT) combined with short-term androgen-deprivation therapy (ADT) in patients with PLN recurrence are associated with a significantly higher risk of recurrence compared to more comprehensive approaches. Emerging data support the role of elective nodal radiotherapy (ENRT) combined with short-term androgen deprivation therapy (ADT) and radiotherapy boost to the PLN metastases to enhance disease control. Notably, despite treating a more extensive pelvic region than MDT, ENRT does not appear to significantly increase acute toxicity or negatively impact quality of life (QoL). Recent evidence suggests a role for androgen receptor pathway inhibitors (ARPI), such as enzalutamide, in patients with high-risk biochemical recurrence, introducing a new treatment paradigm for patients ineligible for salvage radiotherapy. Ongoing prospective studies are refining the role of radiotherapy in combination with systemic treatments. SUMMARY: Despite PSMA-PET allowing for improved staging and better patient-tailored decisions, patients with PLN recurrence continue to benefit from comprehensive multimodal treatment approach. Elective PLN irradiation combined with radiotherapy boost and ADT lead to improved disease control, without compromising safety and toxicity. ARPI+ADT and ARPI-monotherapy emerge as alternatives for select patients.

Indexed as

Lymphatic IrradiationLymph NodesNeoplasm Recurrence, LocalProstatic NeoplasmsAndrogen AntagonistsHumansLymphatic MetastasisMaleNeoplasm StagingPelvisQuality of LifeTreatment OutcomeAndrogen Antagonistslocalneoplasm recurrencepelvic radiotherapyPETprostatic neoplasmsalvage therapy

Identifiers

PMID40654037
PMCPMC12337913

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.