scholarly journals PSMA-Ligand Uptake Can Serve as a Novel Biomarker in Primary Prostate Cancer to Predict Outcome After Radical Prostatectomy

2021 ◽  
Author(s):  
Hui Wang ◽  
Thomas Amiel ◽  
Christoph Würnschimmel ◽  
Thomas Langbein ◽  
Katja Steiger ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Pet Imaging ◽  
Surgical Margin ◽  
Disease Outcome ◽  
Imaging Biomarker ◽  
Psma Ligand ◽  
Primary Prostate Cancer

Abstract BackgroundThe prostate-specific membrane antigen (PSMA) is a relevant target in prostate cancer and immunohistochemistry studies showed associations with outcome. PSMA-ligand positron emission tomography (PET) is increasingly used for primary prostate cancer staging and the molecular imaging TNM classification (miTNM) standardizes its reporting. We aimed to investigate the potential of PET-imaging to serve as a noninvasive imaging biomarker to predict disease outcome in primary prostate cancer after radical prostatectomy (RP).MethodsIn this retrospective analysis, 186 primary prostate cancer patients treated with RP who had undergone a 68Ga-PSMA-11 PET up to three months prior to the surgery were included. Maximum standardized uptake value (SUVmax), SUVmean, tumor volume (TV) and total lesion (TL) were collected from PET-imaging. Moreover, clinicopathological information, including age, serum prostate-specific antigen (PSA) level, and pathological characteristics were assessed for disease outcome prediction. A stage group system for PET-imaging findings based on the miTNM framework was developed. ResultsAt a median follow-up after RP of 38 months (interquartile range (IQR): 22-53), biochemical recurrence (BCR) was observed in 58 patients during the follow-up period. A significant association between a positive surgical margin and miN status (miN1 vs. miN0, odds ratio (OR): 5.428, p=0.004) was detected. miT status (miT≥3a vs. miT<3, OR: 2.696, p=0.003) was identified as an independent predictor for Gleason score (GS)≥8. Multivariate Cox regression analysis indicated that PSA level (hazard ratio (HR): 1.024, p=0.014), advanced GS (GS≥8 vs. GS<8, HR: 3.253, p<0.001) and miT status (miT≥3a vs. miT<3, HR: 1.941, p=0.035) were independent predictors for BCR. For stage I disease as determined by PET-imaging a shorter BCR-free survival was observed in the patients with higher SUVmax (IA vs. IB stage, log-rank, p=0.022).ConclusionPreoperative miTNM classification from 68Ga-PSMA-11 PET correlates with postoperative GS, surgical margin status and time to BCR. The association between miTNM staging and outcome proposes 68Ga-PSMA-11 PET as a novel non-invasive imaging biomarker and potentially serves for ancillary pre-treatment stratification. Prospective studies with larger cohort are necessary to fully determine its use including primary prostate cancer patients with different treatments and risk categories and late-stage patients.

scholarly journals PSMA-ligand uptake can serve as a novel biomarker in primary prostate cancer to predict outcome after radical prostatectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hui Wang ◽  
Thomas Amiel ◽  
Christoph Würnschimmel ◽  
Thomas Langbein ◽  
Katja Steiger ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Pet Imaging ◽  
Surgical Margin ◽  
Disease Outcome ◽  
Imaging Biomarker ◽  
Cox Regression Analysis ◽  
Psma Ligand ◽  
Primary Prostate Cancer

Abstract Background The prostate-specific membrane antigen (PSMA) is a relevant target in prostate cancer, and immunohistochemistry studies showed associations with outcome. PSMA-ligand positron emission tomography (PET) is increasingly used for primary prostate cancer staging, and the molecular imaging TNM classification (miTNM) standardizes its reporting. We aimed to investigate the potential of PET-imaging to serve as a noninvasive imaging biomarker to predict disease outcome in primary prostate cancer after radical prostatectomy (RP). Methods In this retrospective analysis, 186 primary prostate cancer patients treated with RP who had undergone a 68Ga-PSMA-11 PET up to three months prior to the surgery were included. Maximum standardized uptake value (SUVmax), SUVmean, tumor volume (TV) and total lesion (TL) were collected from PET-imaging. Moreover, clinicopathological information, including age, serum prostate-specific antigen (PSA) level, and pathological characteristics, was assessed for disease outcome prediction. A stage group system for PET-imaging findings based on the miTNM framework was developed. Results At a median follow-up after RP of 38 months (interquartile range (IQR) 22–53), biochemical recurrence (BCR) was observed in 58 patients during the follow-up period. A significant association between a positive surgical margin and miN status (miN1 vs. miN0, odds ratio (OR): 5.428, p = 0.004) was detected. miT status (miT ≥ 3a vs. miT < 3, OR: 2.696, p = 0.003) was identified as an independent predictor for Gleason score (GS) ≥ 8. Multivariate Cox regression analysis indicated that PSA level (hazard ratio (HR): 1.024, p = 0.014), advanced GS (GS ≥ 8 vs. GS < 8, HR: 3.253, p < 0.001) and miT status (miT ≥ 3a vs. miT < 3, HR: 1.941, p = 0.035) were independent predictors for BCR. For stage I disease as determined by PET-imaging, a shorter BCR-free survival was observed in the patients with higher SUVmax (IA vs. IB stage, log-rank, p = 0.022). Conclusion Preoperative miTNM classification from 68Ga-PSMA-11 PET correlates with postoperative GS, surgical margin status and time to BCR. The association between miTNM staging and outcome proposes 68Ga-PSMA-11 PET as a novel non-invasive imaging biomarker and potentially serves for ancillary pre-treatment stratification.

scholarly journals Patient triggered follow up (PTFU) for prostate cancer patients post radiotherapy and radical prostatectomy

2020 ◽  
Vol 19 ◽  
pp. e241-e242
Author(s):  
W.J.H. Struss ◽  
A. Garrett ◽  
K. Hamer ◽  
C. Marsh ◽  
E. Chedgy ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients

Relapse and cure rates of prostate cancer patients after radical prostatectomy and 5 years of follow-up

2000 ◽  
Vol 33 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Evyenia J.K. Vassilikos ◽  
He Yu ◽  
John Trachtenberg ◽  
Robert K. Nam ◽  
Steven A. Narod ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Cure Rates

scholarly journals Long term outcomes between adjuvant radiotherapy and combined radiotherapy with hormonal treatment after radical prostatectomy in high risk prostate cancer

2021 ◽  
Vol 42 (1) ◽  
pp. 7-12
Author(s):  
Chalermchai Kiatbamrungpunt, ◽  
◽  
Chaiyong Nualyong ◽  
Sittiporn Srinualnad ◽  
Sunai Leewansangtong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Combined Treatment ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

Objective: To determine the oncological outcome of adjuvant treatment between radiotherapy (RT) alone and combined radiotherapy with androgen deprivation therapy (ADT) in high risk prostate cancer patients after radical prostatectomy (RP). Materials and Methods: All medical records of high risk-prostate cancer patients (including PSA > 20 ng/ml, pT3-pT4 or Gleason score 8-10) who underwent RP in Siriraj Hospital between 2000 and 2016 were retrospectively reviewed. Demo-graphic data, pathological staging, types of adjuvant treatment, time to follow up and time to biochemical recurrence (BCR) were analyzed. Results: Undetectable PSA after RP was achieved in 1009 out of 1221 high risk prostate cancer patients who had been followed up at least 6 months after surgery. Pathological staging pT2, pT3, pT4 and N1 was 23.8%, 73%, 0.8% and 4.7%, respectively. Forty one percent received adjuvant treatment (41 adjuvant RT alone, 74 combined adjuvant RT and ADT, 303 ADT alone). Median follow up time in the adjuvant RT group and combined treatment group was 63.8 months (8.9 - 210.7). BCR rates were 22% (9 of 41) for adjuvant RT and 12.2% (9 of 74) for adjuvant combined treatment. 10-year BCR-free survival in the two groups was 70.2% and 83.8%, respectively. There was no statistical difference between adjuvant RT and adjuvant combined treatment in terms of survival benefit (Hazard Ratio 0.40; p = 0.057). Conclusion: Adjuvant radiotherapy after radical prostatectomy increases long term survival outcomes for high risk prostate cancer patients. This study shows that combined adjuvant RT and ADT may improve BCR-free survival.

Tumor contact length used as a biomarker to predict extracapsular extension, lymph node involvement, and biochemical recurrence.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16588-e16588
Author(s):  
Públio Viana ◽  
Thiana Rodrigues ◽  
Davi alves martins Mota ◽  
Giuliano Guglielmetti ◽  
Diogo Assed Bastos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Magnetic Resonance ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Specific Antigen ◽  
Contact Length ◽  
Imaging Biomarker ◽  
Exclusion Criterion

e16588 Background: Prostate cancer (PC) is the cancer most commonly diagnosed in men and the second leading cause of death. Multiparametric magnetic resonance imaging (mpMRI) is the benchmark imaging standard for local staging of PC. Patients with pathological extraprostatic tumor (pEPE) have a worse prognosis than those with confined organ disease with a higher risk of biochemical recurrence (BCR) after radical prostatectomy (RP). These factors, in addition to positive lymph nodes (PLN), are pivotal in the decision-making process regarding treatment. However, the subjective MRI analysis has low sensitivity in the detection of EPE and is plagued by the low interobserver agreement. Tumor contact length (TCL) is an objective parameter of mpMRI defined as the length of prostate cancer in contact with the prostate capsule, which may provide additional information about prostate cancer outcomes. We aimed to evaluate TCL as a predictor of pECE, PLN, and BCR in patients undergoing RP. Methods: In this Institutional Review Board approved single-institution prospective study, we update the follow-up of 148 patients and included 31 new patients, with prostate cancer who underwent prostate MRI before radical prostatectomy from March 2014 to november 2018. TCL was measured using T2-weighted magnetic resonance images.Postoperative prostate-specific antigen (PSA) values were obtained every 3 months in the first year, then biannually and annually thereafter. BCR was defined as PSA≥0.2ng/mL. The exclusion criterion was prior treatment. Results: The median follow-up was 44 months. 76/179 (42,4%) patients had pEPE, 12/179 (6,7%) had pLN, and 29/179 (16,2%) had BCR. TCL values were significantly higher in patients with pathological pECE ( 20,6 mm vs 9,9 mm, p < 0.001). Using a cut-off of 11,9 mm we found area under curve (AUC) of 0,71 to predict pathological ECE, with sensitivity 72,5% and specificity 67,5% . Using a cut-off of 16,5 mm we found AUC of 0,64 to predict BCR, with sensitivity 54,2% and specificity 67,8% and with a cut-off of 21,7 mm the AUC to predict PLN was 0,77, with sensitivity 66,7% and specificity 83,6%. Conclusions: We prospectively demonstrated in our population that TCL values were significantly higher in patients with pEPE , PLN and BCR. If validated, this imaging biomarker may facilitate and inform patient counseling and decision-making.

Sign in / Sign up

Export Citation Format

Share Document