PD61-02 PREOPERATIVE PSMA PET/CT AS A PREDICTOR OF BIOCHEMICAL PERSISTENCE AND EARLY BIOCHEMICAL RECURRENCE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy V (PD61)1 Sep 2021PD61-02 PREOPERATIVE PSMA PET/CT AS A PREDICTOR OF BIOCHEMICAL PERSISTENCE AND EARLY BIOCHEMICAL RECURRENCE Diederik Baas, Melline Schilham, Joost de Baaij, Eric Vrijhof, Robert Hoekstra, Rick Hermsen, Diederik Somford, and Jean-Paul van Basten Diederik BaasDiederik Baas More articles by this author , Melline SchilhamMelline Schilham More articles by this author , Joost de BaaijJoost de Baaij More articles by this author , Eric VrijhofEric Vrijhof More articles by this author , Robert HoekstraRobert Hoekstra More articles by this author , Rick HermsenRick Hermsen More articles by this author , Diederik SomfordDiederik Somford More articles by this author , and Jean-Paul van BastenJean-Paul van Basten More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002098.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: This study aims to evaluate the predictive value of suspected lymph nodes (LN) metastases on prostate-specific-membrane-antigen (PSMA) PET/CT for biochemical persistence (BCP) and early biochemical recurrence (BCR) following radical prostatectomy (RP) with extended pelvic lymph node dissection (ePLND). METHODS: RP patients between September 1st, 2016 and October 1st, 2020 were evaluated. Men with intermediate or high-risk PCa with preoperative 68Ga/18F-PSMA PET/CT and subsequent ePLND were included. Performance of PSMA PET/CT was determined on a per patient level. BCP was defined as a serum PSA level ≥0.1 ng/mL between 6-20 weeks following RP. Early BCR was defined as detectable PSA >0.2 ng/mL ≤12 months of follow-up. Patients were grouped as PSMA- or PSMA+ depending on their LN status on PSMA PET/CT and subdivided according to histological LN status (pN) as determined by ePLND. RESULTS: From 1058 consecutive RP patients, 213 met the inclusion criteria. Median number of resected LN was 20 (IQR 15-26). PSMA PET/CT versus histological results of ePLND are presented in Table 1. Sensitivity, specificity, PPV, NPV and accuracy for preoperative detection of metastatic LNs were 29%, 83%, 33%, 80% and 71% respectively. BCP was observed in 26 of 211 patients (12%) and early BCR in 23 of 110 patients (21%). The incidence of BCP and BCR for patients subdivided according to their PSMA and pN status is illustrated in Figure 1. No correction was made for other risk factors. Patients with PSMA+/pN1 had a significantly increased risk of BCP and BCR compared with PSMA-/pN1 (p=0.004; p <0.001). CONCLUSIONS: ePLND should not be avoided in men with a pre-operative negative PSMA PET/CT, as 20% of patients do have histological N1 disease. Men with positive pre-operative PSMA PET/CT and confirmed pN1 disease have a significantly increased risk of BCP and early BCR compared to those with negative PSMA PET/CT. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1066-e1066 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Diederik Baas More articles by this author Melline Schilham More articles by this author Joost de Baaij More articles by this author Eric Vrijhof More articles by this author Robert Hoekstra More articles by this author Rick Hermsen More articles by this author Diederik Somford More articles by this author Jean-Paul van Basten More articles by this author Expand All Advertisement Loading ...