PD57-01 PREDICTING EARLY BIOCHEMICAL PROGRESSION IN PROSTATE CANCER PATIENTS STAGED WITH PSMA PET AND MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV (PD57)1 Sep 2021PD57-01 PREDICTING EARLY BIOCHEMICAL PROGRESSION IN PROSTATE CANCER PATIENTS STAGED WITH PSMA PET AND MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING Dennie Meijer, Pim van Leeuwen, Maarten Donswijk, Thierry Boellaard, Ivo Schoots, Henk van der Poel, Harry Hendrikse, Daniela Oprea-Lager, and André Vis Dennie MeijerDennie Meijer More articles by this author , Pim van LeeuwenPim van Leeuwen More articles by this author , Maarten DonswijkMaarten Donswijk More articles by this author , Thierry BoellaardThierry Boellaard More articles by this author , Ivo SchootsIvo Schoots More articles by this author , Henk van der PoelHenk van der Poel More articles by this author , Harry HendrikseHarry Hendrikse More articles by this author , Daniela Oprea-LagerDaniela Oprea-Lager More articles by this author , and André VisAndré Vis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002091.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of this study was to point out predictors for early oncological outcome in patients who opt for robot-assisted laparoscopic radical prostatectomy (RARP) for localized prostate cancer (PCa) including conventional prognostic variables as well as multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging. METHODS: This observational study included 500 patients who underwent RARP and extended pelvic lymph node dissection (ePLND). Outcome measurement was biochemical progression of disease, defined as any post-operative PSA ≥0.2 ng/mL. A Cox-regression analysis was performed to assess predictors for biochemical progression, including initial prostate-specific antigen (PSA)-value, biopsy Grade Group (GG), T-stage on mpMRI, and lymph node status on PSMA PET imaging (miN0 vs. miN1). RESULTS: The median total follow-up of all included patients was 12.8 months (IQR 6.6-22.3). When assessing biochemical progression after surgery, initial PSA-value (per doubling; OR 1.24 (95%CI 1.08-1.43), p=0.003), biopsy GG ≥4 vs. GG 1-2 (OR 2.33 (95%CI 1.47-3.69), p<0.001), T-stage on mpMRI (rT3a vs. rT2: OR 2.04 (95%CI 1.30-3.20), p=0.002; ≥rT3b vs. rT2: OR 4.87 (95%CI 3.24-7.32), p<0.001) and miN1 on PSMA PET imaging (OR 2.16 (95%CI 1.46-3.20), p<0.001) were independent predictors of biochemical progression of disease. Moreover, the number of pelvic lymph node metastases on PSMA PET was significantly associated with biochemical progression: one pelvic lymph node metastasis vs. no metastatic disease resulted in an OR 2.60 (95%CI 1.57-4.31), p<0.001; two pelvic lymph node metastases or more on PSMA PET vs. no metastatic disease resulted in an OR 4.61 (95%CI 2.84-7.48), p<0.001. CONCLUSIONS: Initial PSA-value, biopsy GG ≥4, ≥rT3 disease on mpMRI and miN1 disease on PSMA PET were predictors for early biochemical progression after RARP. Furthermore, the number of pelvic lymph node metastases on staging PSMA PET was associated with biochemical progression. Identifying patients with an increased risk of biochemical progression after surgery may have implications for patient counseling in radical treatment decisions and on patient selection for modern (neo-)adjuvant and systematic treatments. Source of Funding: No funding was received for conducting this study. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1009-e1009 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dennie Meijer More articles by this author Pim van Leeuwen More articles by this author Maarten Donswijk More articles by this author Thierry Boellaard More articles by this author Ivo Schoots More articles by this author Henk van der Poel More articles by this author Harry Hendrikse More articles by this author Daniela Oprea-Lager More articles by this author André Vis More articles by this author Expand All Advertisement Loading ...