MP67-02 SALVAGE ROBOT-ASSISTED PSMA-RADIOGUIDED SURGERY IN RECURRENT PROSTATE CANCER USING A NOVEL DROP-IN GAMMA PROBE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP67-02 SALVAGE ROBOT-ASSISTED PSMA-RADIOGUIDED SURGERY IN RECURRENT PROSTATE CANCER USING A NOVEL DROP-IN GAMMA PROBE Fabian Falkenbach, Sophie Knipper, Daniel Koehler, Fijs W.B. Van Leeuwen, Matthias N. Van Oosterom, Pim Van Leeuwen, Hilda De Barros, Henk Van Der Poel, Lars Budäus, Thomas Steuber, Markus Graefen, and Tobias Maurer Fabian FalkenbachFabian Falkenbach More articles by this author , Sophie KnipperSophie Knipper More articles by this author , Daniel KoehlerDaniel Koehler More articles by this author , Fijs W.B. Van LeeuwenFijs W.B. Van Leeuwen More articles by this author , Matthias N. Van OosteromMatthias N. Van Oosterom More articles by this author , Pim Van LeeuwenPim Van Leeuwen More articles by this author , Hilda De BarrosHilda De Barros More articles by this author , Henk Van Der PoelHenk Van Der Poel More articles by this author , Lars BudäusLars Budäus More articles by this author , Thomas SteuberThomas Steuber More articles by this author , Markus GraefenMarkus Graefen More articles by this author , and Tobias MaurerTobias Maurer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003330.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Positron emission tomography / computed tomography (PET/CT) directed against the prostate-specific membrane antigen (PSMA) allows detection of even small and/or atypically localized metastatic prostate cancer (PCa) lesions at low PSA values. In a subset of patients with recurrent oligometastatic localized PCa PSMA-targeted radioguided surgery (PSMA-RGS) might be of value. Recently, a DROP-IN gamma-probe for intraoperative detection of metastatic lesions was introduced to facilitate a robot-assisted minimally invasive approach. Here, we report on our experience and the outcome of the first 16 patients treated with PSMA-RGS using the DROP-IN probe. METHODS: We assessed 16 patients treated with robot-assisted PSMA-RGS between 05/2021 and 03/2022. All patients presented with biochemical recurrence after radical prostatectomy (RP) and soft-tissue lesions on PSMA PET. Histological correlation, early PSA responses and Clavien-Dindo complications were evaluated. RESULTS: Median age was 64 years (IQR: 56-70.5 years). Prior to PSMA-RGS, overall median PSA was 0.55 ng/ml (IQR: 0.35-0.82 ng/ml). At robotic PSMA-RGS, intraoperative blood loss was estimated with 50 ml (IQR: 50-100 ml) and OR time was 158 minutes (IQR: 139-173 minutes). Metastatic soft-tissue lesions from PCa metastases could be removed in 15 (94%) patients. Postoperatively, overall median PSA was 0.18 ng/ml (IQR: 0.05-0.27 ng/ml). During the median follow-up of 4.2 months (IQR: 1.0-5.8 months), 4 patients experienced BCR and 1 patient received further therapy. One patient suffered from a Clavien-Dindo complication grade IIIb within three months from surgery (intraabdominal fluid collection necessitating drainage in general anesthesia). Limitations are the retrospective design and lack of a control group, as well as the small cohort. CONCLUSIONS: Robot-assisted PSMA-RGS using the novel DROP-IN gamma probe is a promising tool to enhance intraoperative detection of metastatic lesions in PCa during salvage surgery in a minimally invasive fashion. Further studies are needed to confirm our findings. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e943 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fabian Falkenbach More articles by this author Sophie Knipper More articles by this author Daniel Koehler More articles by this author Fijs W.B. Van Leeuwen More articles by this author Matthias N. Van Oosterom More articles by this author Pim Van Leeuwen More articles by this author Hilda De Barros More articles by this author Henk Van Der Poel More articles by this author Lars Budäus More articles by this author Thomas Steuber More articles by this author Markus Graefen More articles by this author Tobias Maurer More articles by this author Expand All Advertisement PDF downloadLoading ...