Thomas Amiel1, Christoph Würnschimmel2,3, Matthias Heck1, Thomas Horn1, Noemi Nguyen1, Lars Budäus2, Sophie Knipper2, Mike Wenzel3,4, Isabel Rauscher5, Matthias Eiber5, Hui Wang5, Tobias Maurer2,6. 1. Department of Urology, Technical University of Munich, Munich, Germany. 2. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 3. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. 4. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 5. Department of Nuclear Medicine, Technical University of Munich, Munich, Germany. 6. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Abstract
PURPOSE: We sought to address the impact of preoperative prostate specific membrane antigen (PSMA) positron emission tomography (PET) findings prior to radical prostatectomy and pelvic lymph node dissection on biochemical recurrence and time to adjuvant or salvage treatment. MATERIALS AND METHODS: Between 2013 and 2017, 64 intermediate and 166 high risk (230) prostate cancer patients received 68Ga-PSMA-11 PET followed by radical prostatectomy and pelvic lymph node dissection. Biochemical recurrence-free and therapy-free survivalwere determined. For all time-to-event analyses, univariable and multivariable Cox proportional hazards models and univariable Kaplan-Meier analyses were applied, with a significance threshold of p <0.05. RESULTS: The overall sensitivity, specificity, positive predictive value and negative predictive value of PSMA PET for pN1 disease was 48.5%, 95.7%, 82.1% and 82.2%, respectively. Median followup was 30.2 months. Biochemical recurrence occurred in 50.4% (116) of patients and adjuvant or salvage treatment was performed in 46.5% (107). Worst biochemical recurrence-free and therapy-free survival was observed in pN1 patients who also exhibited PSMA PET positive lymph node, followed by pN1 patients without PSMA PET positive lymph node and patients without evidence of lymph node metastasis on histology and PSMA PET (median biochemical recurrence-free survival 1.7 vs. 7.5 vs. >36 months, median therapy-free survival 2.6 vs. 8.9 vs. >36 months). CONCLUSIONS: Patients with positive lymph node on PSMA PET prior to radical prostatectomy have to expect early biochemical recurrence and adjuvant/salvage therapy, despite thorough pelvic lymph node dissection. Therefore, results from PSMA PET can be used for patients' consultation and more stringent followup as well as for planning of neoadjuvant/adjuvant therapy.
PURPOSE: We sought to address the impact of preoperative prostate specific membrane antigen (PSMA) positron emission tomography (PET) findings prior to radical prostatectomy and pelvic lymph node dissection on biochemical recurrence and time to adjuvant or salvage treatment. MATERIALS AND METHODS: Between 2013 and 2017, 64 intermediate and 166 high risk (230) prostate cancerpatients received 68Ga-PSMA-11 PET followed by radical prostatectomy and pelvic lymph node dissection. Biochemical recurrence-free and therapy-free survivalwere determined. For all time-to-event analyses, univariable and multivariable Cox proportional hazards models and univariable Kaplan-Meier analyses were applied, with a significance threshold of p <0.05. RESULTS: The overall sensitivity, specificity, positive predictive value and negative predictive value of PSMA PET for pN1 disease was 48.5%, 95.7%, 82.1% and 82.2%, respectively. Median followup was 30.2 months. Biochemical recurrence occurred in 50.4% (116) of patients and adjuvant or salvage treatment was performed in 46.5% (107). Worst biochemical recurrence-free and therapy-free survival was observed in pN1patients who also exhibited PSMA PET positive lymph node, followed by pN1patients without PSMA PET positive lymph node and patients without evidence of lymph node metastasis on histology and PSMA PET (median biochemical recurrence-free survival 1.7 vs. 7.5 vs. >36 months, median therapy-free survival 2.6 vs. 8.9 vs. >36 months). CONCLUSIONS:Patients with positive lymph node on PSMA PET prior to radical prostatectomy have to expect early biochemical recurrence and adjuvant/salvage therapy, despite thorough pelvic lymph node dissection. Therefore, results from PSMA PET can be used for patients' consultation and more stringent followup as well as for planning of neoadjuvant/adjuvant therapy.
Authors: Hossein Jadvar; Jeremie Calais; Stefano Fanti; Felix Feng; Kirsten L Greene; James L Gulley; Michael Hofman; Bridget F Koontz; Daniel W Lin; Michael J Morris; Steve P Rowe; Trevor J Royce; Simpa Salami; Bital Savir-Baruch; Sandy Srinivas; Thomas A Hope Journal: J Nucl Med Date: 2021-09-30 Impact factor: 11.082
Authors: Michael Xiang; Ting Martin Ma; Ricky Savjani; Erqi L Pollom; R Jeffrey Karnes; Tristan Grogan; Jessica K Wong; Giovanni Motterle; Jeffrey J Tosoian; Bruce J Trock; Eric A Klein; Bradley J Stish; Robert T Dess; Daniel E Spratt; Avinash Pilar; Chandana Reddy; Rebecca Levin-Epstein; Trude B Wedde; Wolfgang A Lilleby; Ryan Fiano; Gregory S Merrick; Richard G Stock; D Jeffrey Demanes; Brian J Moran; Hartwig Huland; Phuoc T Tran; Santiago Martin; Rafael Martinez-Monge; Daniel J Krauss; Eyad I Abu-Isa; Ridwan Alam; Zeyad Schwen; Thomas M Pisansky; C Richard Choo; Daniel Y Song; Stephen Greco; Curtiland Deville; Todd McNutt; Theodore L DeWeese; Ashley E Ross; Jay P Ciezki; Paul C Boutros; Nicholas G Nickols; Prashant Bhat; David Shabsovich; Jesus E Juarez; Natalie Chong; Patrick A Kupelian; Matthew B Rettig; Nicholas G Zaorsky; Alejandro Berlin; Jonathan D Tward; Brian J Davis; Robert E Reiter; Michael L Steinberg; David Elashoff; Eric M Horwitz; Rahul D Tendulkar; Derya Tilki; Johannes Czernin; Andrei Gafita; Tahmineh Romero; Jeremie Calais; Amar U Kishan Journal: JAMA Netw Open Date: 2021-12-01
Authors: Yves J L Bodar; Hans Veerman; Dennie Meijer; Katelijne de Bie; Pim J van Leeuwen; Maarten L Donswijk; R Jeroen A van Moorselaar; N Harry Hendrikse; Ronald Boellaard; Daniela E Oprea-Lager; André N Vis Journal: BJU Int Date: 2022-03-12 Impact factor: 5.969