You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) I (PD05)1 Sep 2021PD05-09 PET/CT ALLOWS FOR A RELIABLE ASSESSMENT OF THE REAL NODAL BURDEN IN CLINICALLY NODE-POSITIVE PROSTATE CANCER PATIENTS CANDIDATE FOR RADICAL PROSTATECTOMY: RESULTS FROM A MULTI-INSTITUTIONAL SERIES Giorgio Gandaglia, R. Jeffrey Karnes, Charlien Berghen, Wouter Everaerts, Gaëtan Devos, Steven Joniau, Daniele Robesti, Armando Stabile, Simone Scuderi, Francesco Barletta, Vito Cucchiara, Elio Mazzone, Giuseppe Rosiello, Andrea Salonia, Pierre I Karakiewicz, Hendrik Van Poppel, Francesco Montorsi, and Alberto Briganti Giorgio GandagliaGiorgio Gandaglia More articles by this author , R. Jeffrey KarnesR. Jeffrey Karnes More articles by this author , Charlien BerghenCharlien Berghen More articles by this author , Wouter EveraertsWouter Everaerts More articles by this author , Gaëtan DevosGaëtan Devos More articles by this author , Steven JoniauSteven Joniau More articles by this author , Daniele RobestiDaniele Robesti More articles by this author , Armando StabileArmando Stabile More articles by this author , Simone ScuderiSimone Scuderi More articles by this author , Francesco BarlettaFrancesco Barletta More articles by this author , Vito CucchiaraVito Cucchiara More articles by this author , Elio MazzoneElio Mazzone More articles by this author , Giuseppe RosielloGiuseppe Rosiello More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Pierre I KarakiewiczPierre I Karakiewicz More articles by this author , Hendrik Van PoppelHendrik Van Poppel More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001969.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: PET/CT scan might identify nodal metastases in prostate cancer (PCa) patients considered for radical prostatectomy (RP). No data addressed the performance characteristics and prognostic value of a positive PET/CT in the nodes for the identification of men more likely to recur METHODS: 346 patients treated with RP and an extended lymph node dissection (LND) with pelvic or retroperitoneal lymphadenopathies at cross-sectional abdominal imaging (n=283 81.8%) vs. choline or PSMA PET/CT (n=63 18.2%) were identified. Lowess analyses explored the non-linear relationship between the number of positive spots and pathologically positive nodes according to imaging (cross-sectional vs PET/CT). Kaplan-Meier analyses assessed time to biochemical recurrence (BCR) in the PET/CT cohort after stratifying patients according to the number of lymphadenopathies. The best cut-off for the number of lymphadenopathies at PET/CT predicting BCR was determined RESULTS: The rate of pN1 disease (74 vs 69%), the number of nodes removed (25 vs 24) and of positive nodes (2 vs 2) at LND did not differ (all P≥0.2). The site of lymphadenopathies was the pelvis only and the pelvis ± retroperitoneum in 84 vs. 88% and 16 vs 12% patients (p=0.3). Cross-sectional imaging was associated with underestimation of nodal burden when ≥2 lymphadenopathies were detected. PET/CT was characterized by excellent concordance with the number of positive nodes at RP. Median follow-up was 70 months and 183 patients experienced BCR. For PET/CT, the most-informative cut-off predicting BCR was 2 clinical lymphadenopathies. When patients selected based on PET/CT were stratified according to the number of positive spots (1 vs ≥2), the 3-year BCR-free survival rates were 48 vs. 21% (p=0.03). This was consistent to what observed when stratifying patients according to the number of positive nodes at final pathology (41 vs 23% p=0.04) CONCLUSIONS: While conventional imaging underestimates the nodal burden, PET/CT is characterized by excellent concordance with final pathology. This resulted in a more reliable prediction of BCR, where the presence of ≥2 positive spots at PET/CT might identify men more likely to experience early recurrence. Source of Funding: - © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e58-e59 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giorgio Gandaglia More articles by this author R. Jeffrey Karnes More articles by this author Charlien Berghen More articles by this author Wouter Everaerts More articles by this author Gaëtan Devos More articles by this author Steven Joniau More articles by this author Daniele Robesti More articles by this author Armando Stabile More articles by this author Simone Scuderi More articles by this author Francesco Barletta More articles by this author Vito Cucchiara More articles by this author Elio Mazzone More articles by this author Giuseppe Rosiello More articles by this author Andrea Salonia More articles by this author Pierre I Karakiewicz More articles by this author Hendrik Van Poppel More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Loading ...