PD57-09 CLINICAL IMPACT OF GALLIUM-PROSTATE SPECIFIC MEMBRANE ANTIGEN (GA-PSMA) POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY (PET/CT) IN PATIENTS WITH PROSTATE CANCER AND BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV (PD57)1 Sep 2021PD57-09 CLINICAL IMPACT OF GALLIUM-PROSTATE SPECIFIC MEMBRANE ANTIGEN (GA-PSMA) POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY (PET/CT) IN PATIENTS WITH PROSTATE CANCER AND BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY Aysa Mosquera, Rodolfo Varela, Marino abrera, Fabian Godoy, Byron Lopez de mesa, Jorge Forero, Luis Becerra, Diego Camacho, and Laura Serna Aysa MosqueraAysa Mosquera More articles by this author , Rodolfo VarelaRodolfo Varela More articles by this author , Marino abrera Marino abrera More articles by this author , Fabian GodoyFabian Godoy More articles by this author , Byron Lopez de mesaByron Lopez de mesa More articles by this author , Jorge ForeroJorge Forero More articles by this author , Luis BecerraLuis Becerra More articles by this author , Diego CamachoDiego Camacho More articles by this author , and Laura SernaLaura Serna More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002091.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Biochemical recurrence (BCR) in prostate cancer occurs in 27 to 53% of patients with radical prostatectomy or radiotherapy. New diagnostic imaging like Gallium-prostate specific membrane antigen (Ga-PSMA) positron emission tomography/computed tomography (PET/CT) has increased drastically as it allows a better understanding of BCR. This study aims to evaluate the clinical impact of Ga-PSMA PET/CT in treatment of patients with prostate cancer and biochemical recurrence after radical prostatectomy. METHODS: Patients with BCR after radical prostatectomy with Ga-PSMA PET/CT from 2018 to 2020 were included. Seven urology oncologists selected options of treatment before Ga-PSMA PET/CT results. Each patient was then studied by a medical board that included radiotherapist, urologist, oncologist and nuclear medicine experts with the results of the Ga-PSMA PET/CT and definitive treatment was selected. Descriptive statistics were used for demographic and clinical variables. Change of management after PSMA PET was analyzed using X2 test. RESULTS: Fifty patients were included. The mean age was 67 years old. Clinical staging using the TNM system reported that 76% of the patients were pT3, 20% N1 and 48% R1. The 54% of patients had a positive Ga-PSMA PET/CT with intra-pelvic lesions in the 73.6% and 26.4% extra-pelvic extension. Salvage radiotherapy was initially selected for 30% of patients and after Ga-PSMA PET/CT increased to 44%, salvage lymphadenectomy went from 0% to 14%. Use of hormone therapy was higher prior to PSMA PET with 18% in contrast to 8% after the use of advanced diagnostic imaging. And finally, active surveillance was more prevalent in the group prior to Ga-PSMA PET/CT with 52% vs. 28%.It was found that 41% of patients had a change of management after use of Ga-PSMA PET/CT. In the subgroup of patients with a positive Ga-PSMA PET/CT the 70.3% had a re-adjustment of treatment in contrast to negative Ga-PSMA PET/CT subgroup with just 9.1% (p=<0.001). In general, modification of systemic to focal treatment increased from 30 to 64%. CONCLUSIONS: The clinical impact of Ga-PSMA PET/CT in BCR in our study was 41% with a significant increase in focal treatment and decrease of systemic ones. Our results support the use of PSMA PET for patients with BCR after radical prostatectomy. We consider it should be used routinely in the clinical practice because it allows a better understanding of the disease and a more target therapy for every patient. Source of Funding: own © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1013-e1013 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aysa Mosquera More articles by this author Rodolfo Varela More articles by this author Marino abrera More articles by this author Fabian Godoy More articles by this author Byron Lopez de mesa More articles by this author Jorge Forero More articles by this author Luis Becerra More articles by this author Diego Camacho More articles by this author Laura Serna More articles by this author Expand All Advertisement Loading ...