Tracer-Guided Surgery for Recurrent Prostate Cancer

Inclusion Criteria: * Male, aged ≥ 18 years. * Hormone-sensitive recurrent prostate cancer after radical prostatectomy, external beam radiotherapy or brachytherapy * ≤ 2 lymph node metastases or local residual disease within the pelvis with sufficient PSMA expression (≥2 times regional vascular activity level) as determined by PSMA-based PET * PSA-value \< 4 ng/mL in case of a local recurrence and PSA \< 3 ng/ml in case of (a) nodal recurrence(s) * Had a PSMA PET/CT within 90 days before surgery * Suitable for salvage surgery, as per institutional guidelines. * Charlson Comorbidity Index ≤ 4 * World Health Organisation (WHO) performance status 0, 1, or 2. * Written and signed informed consent. Exclusion Criteria: * Other diagnosis of malignancy or evidence of other malignancy within 5 years before screening for this study (except non-melanoma skin cancer). * More than 2 lymph node metastases on PSMA PET/CT * Suspicion of local recurrent prostate cancer within the prostatic fossa not treatable by surgery * Non-regional lymphadenopathy (cM1a) or distant metastases (cM1b/c) as assessed by preoperative PSMA PET/CT. * Castration resistance defined by clinical or biochemical progression despite a combined androgen blockade * Known contraindications to hormone therapy, according to standard recommendations in force * Patient with a psychological, familial, sociological or geographical situation potentially hampering compliance with the study protocol and follow-up schedule * Ongoing androgen deprivation therapy (ADT) or within 6 months prior to surgery. * Severe claustrophobia interfering with PET/CT scanning. * Absence or withdrawal of an informed consent