| Title: |
The prognostic significance of a negative PSMA-PET scan prior to salvage radiotherapy following radical prostatectomy |
| Authors: |
Adebahr, Sonja; Althaus, Alexander; Scharl, Sophia; Strouthos, Iosif; Farolfi, Andrea; Serani, Francesca; Lanzafame, Helena; Trapp, Christian; Koerber, Stefan A; Peeken, Jan C; Vogel, Marco M E; Vrachimis, Alexis; Spohn, Simon K B; Grosu, Anca-Ligia; Kroeze, Stephanie G C; Guckenberger, Matthias; Fanti, Stefano; Hruby, George; Emmett, Louise; Belka, Claus; Schmidt-Hegemann, Nina-Sophie; Henkenberens, Christoph; Aebersold, Daniel M; Wiegel, Thomas; Afshar-Oromieh, Ali; Zamboglou, Constantinos; Shelan, Mohamed |
| Source: |
Adebahr, Sonja; Althaus, Alexander; Scharl, Sophia; Strouthos, Iosif; Farolfi, Andrea; Serani, Francesca; Lanzafame, Helena; Trapp, Christian; Koerber, Stefan A; Peeken, Jan C; Vogel, Marco M E; Vrachimis, Alexis; Spohn, Simon K B; Grosu, Anca-Ligia; Kroeze, Stephanie G C; Guckenberger, Matthias; Fanti, Stefano; Hruby, George; Emmett, Louise; Belka, Claus; Schmidt-Hegemann, Nina-Sophie; Henkenberens, Christoph; Aebersold, Daniel M; Wiegel, Thomas; Afshar-Oromieh, Ali; Zamboglou, Constantinos; Shelan, Mohamed (2024). The prognostic significance of a negative PSMA-PET scan prior to salvage radiotherapy following radical prostatectomy. European Journal of Nuclear Medicine and Molecular Imaging, 51(2):558-567. |
| Publisher Information: |
Springer |
| Publication Year: |
2024 |
| Collection: |
University of Zurich (UZH): ZORA (Zurich Open Repository and Archive |
| Subject Terms: |
Clinic for Radiation Oncology; 610 Medicine & health |
| Description: |
AIM The optimal management for early recurrent prostate cancer following radical prostatectomy (RP) in patients with negative prostate-specific membrane antigen positron-emission tomography (PSMA-PET) scan is an ongoing subject of debate. The aim of this study was to evaluate the outcome of salvage radiotherapy (SRT) in patients with biochemical recurrence with negative PSMA PET finding. METHODS This retrospective, multicenter (11 centers, 5 countries) analysis included patients who underwent SRT following biochemical recurrence (BR) of PC after RP without evidence of disease on PSMA-PET staging. Biochemical recurrence-free survival (bRFS), metastatic-free survival (MFS) and overall survival (OS) were assessed using Kaplan-Meier method. Multivariable Cox proportional hazards regression assessed predefined predictors of survival outcomes. RESULTS Three hundred patients were included, 253 (84.3%) received SRT to the prostate bed only, 46 (15.3%) additional elective pelvic nodal irradiation, respectively. Only 41 patients (13.7%) received concomitant androgen deprivation therapy (ADT). Median follow-up after SRT was 33 months (IQR: 20-46 months). Three-year bRFS, MFS, and OS following SRT were 73.9%, 87.8%, and 99.1%, respectively. Three-year bRFS was 77.5% and 48.3% for patients with PSA levels before PSMA-PET ≤ 0.5 ng/ml and > 0.5 ng/ml, respectively. Using univariate analysis, the International Society of Urological Pathology (ISUP) grade > 2 (p = 0.006), metastatic pelvic lymph nodes at surgery (p = 0.032), seminal vesicle involvement (p < 0.001), pre-SRT PSA level of > 0.5 ng/ml (p = 0.004), and lack of concomitant ADT (p = 0.023) were significantly associated with worse bRFS. On multivariate Cox proportional hazards, seminal vesicle infiltration (p = 0.007), ISUP score >2 (p = 0.048), and pre SRT PSA level > 0.5 ng/ml (p = 0.013) remained significantly associated with worse bRFS. CONCLUSION Favorable bRFS after SRT in patients with BR and negative PSMA-PET following RP was achieved. These ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
1619-7070 |
| Relation: |
https://www.zora.uzh.ch/id/eprint/237464/1/2023_Adebahr_37736808.pdf; info:pmid/37736808; urn:issn:1619-7070 |
| Availability: |
https://www.zora.uzh.ch/id/eprint/237464/; https://www.zora.uzh.ch/id/eprint/237464/1/2023_Adebahr_37736808.pdf |
| Rights: |
info:eu-repo/semantics/openAccess ; Creative Commons: Attribution 4.0 International (CC BY 4.0) ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.F0044F90 |
| Database: |
BASE |