Preoperative PSMA-PET/CT as a predictor of biochemical persistence and early recurrence following radical prostatectomy with lymph node dissection

Autor: D J H, Baas, M, Schilham, R, Hermsen, J M S, de Baaij, H J E J, Vrijhof, R J, Hoekstra, J P M, Sedelaar, H V N, Küsters-Vandevelde, M, Gotthardt, C H W, Wijers, J P, van Basten, D M, Somford
Rok vydání: 2021
Předmět:
Zdroj: Prostate cancer and prostatic diseases. 25(1)
ISSN: 1476-5608
Popis: This study aims to evaluate the predictive value of lymph nodes (LN) suspicious for metastases on preoperative prostate-specific membrane antigen (PSMA) PET/CT for biochemical persistence (BCP) and early biochemical recurrence (BCR) following robotic-assisted radical prostatectomy (RARP) with extended pelvic LN dissection (ePLND).We evaluated 213 patients with intermediate and high-risk prostate cancer (PCa) who underwent clinical staging with preoperativeForty patients (19%) were PSMA+. The overall incidence of pN1 was 23%. Sensitivity, specificity, PPV and NPV on a per patient level for the detection of pN1 was 29%, 84%, 35%, and 80% respectively. BCP was observed in 26 of 211 patients (12%) and early BCR in 23 of 110 patients (21%). The presence of PSMA+ was a significant predictor for BCP (OR 7.1, 2.9-17.1 95% CI) and BCR (OR 8.1, 2.9-22.6 95% CI).Preoperative PSMA-PET/CT may be a valuable tool for patient counseling for RARP and ePLND as it is a significant predictor for the risk of postoperative BCP and early BCR. We conclude that an ePLND should not be avoided in men with intermediate or high-risk PCa and preoperative negative PSMA-PET/CT, as 20% have microscopic LN metastasis.
Databáze: OpenAIRE
Externí odkaz: