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Prostate Cancer: Staging (MP11): Moderated Poster 11: Friday, September 10, 2021

MP11-12 REGIONAL LYMPH NODE METASTASIS ON PSMA PET CORRELATES WITH DECREASED BCR-FREE AND THERAPY-FREE SURVIVAL AFTER RADICAL PROSTATECTOMY

Wuernschimmel, Christoph; Amiel, Thomas; Heck, Matthias; Horn, Thomas; Nguyen, Noemi; Budaeus, Lars; Knipper, Sophie; Wenzel, Mike; Rauscher, Isabel; Eiber, Matthias; Wang, Hui; Maurer, Tobias

doi: 10.1097/JU.0000000000001984.12
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INTRODUCTION AND OBJECTIVE:

To address the impact of preoperative PSMA PET (prostate specific membrane antigen positron emission tomography) findings prior to radical prostatectomy (RP) and pelvic lymph node dissection (PLND) on biochemical recurrence (BCR) and time to adjuvant or salvage treatment.

METHODS:

Between 2013 and 2017, 64 intermediate- and 166 high-risk prostate cancer (PCa) patients received 68Ga-PSMA-11 PET followed by RP and PLND. BCR-free and therapy-free survival was determined. For all time to event analyses, uni- and multivariable Cox's proportional hazards models and univariable Kaplan-Meier analyses were applied, with a significance threshold of p<0.05.

RESULTS:

Positive extraprostatic PSMA PET lesions were found in 4 (6.2%) intermediate-risk patients and 47 (28.3%) high-risk patients. 66 (28.7%) of all 230 patients harbored histopathologically positive lymph nodes (LN). Median follow up was 30.2 months. BCR occurred in 50.4% (n=116) of patients and adjuvant or salvage treatment was performed in 46.5% (n=107). Worst BCR-free and therapy-free survival was observed in pN1 patients who also exhibited PSMA PET positive LN, followed by pN1 patients without PSMA PET positive LN and patients without evidence of LN metastasis on histology and PSMA PET (median BCR-free survival 1.7 vs. 7.5 vs. >36 months, median therapy-free survival 2.6 vs. 8.9 vs. >36 months).

CONCLUSIONS:

Patients with positive LN on PSMA PET prior to RP have to expect early BCR and adjuvant/salvage therapy, despite thorough PLND. Therefore, results from PSMA PET can be used for patients´ consultation, more stringent follow-up as well as for planning of neo-/adjuvant therapy.

Source of Funding:

None

© 2021 by American Urological Association Education and Research, Inc.