Examination of high-risk prostate cancer patients: real practice in Russia

Introduction. Approaches to the diagnosis and staging of localized and locally advanced high-risk prostate cancer (PCa-НR) continue to be actively researched and improved. Materials and methods. In order to understand some of the controversial and controversial issues regarding the diagnosis of PCа-НR, a survey was conducted, in which 250 specialists took part – oncourologists, urologists, andrologists, specializing in the treatment / observation of patients with prostate cancer (PCа). The survey was conducted within the urological information portal Uroweb.ru by filling out a questionnaire. Results. The results obtained indicate that the most significant differences were obtained in views on the role of positron emission tomography combined with computed tomography (PET/CT) in the primary diagnosis of non-metastatic PCа and the importance of local prevalence in determining the risk of progression, while the attitude to genetic testing, primary local staging and prognosis criteria after radical prostatectomy in the majority respondents were similar. Conclusions. Most Russian oncourologists specialists involved in the treatment of PCа do not recommend that patients with PCа-HR perform PET/CT with prostate specific membrane antigen (68Ga-PSMA) and do not prescribe geneticist consultation and genetic counseling for non-metastatic PCа. To assess the local prevalence of the process in prostate cancer, based on the results of MRI, digital rectal examination and the percentage of tumor tissue in the biopsy sample. Most specialists determine the prognosis of a patient after RP by summing up the pathomorphological (PSA + radiological diagnostics + the result of histological examination) and clinical (PSA + radiological diagnostics + biopsy) indicators, which quite correlates with the global data.

Download Full-text

[11C]Choline PET/CT in therapy response assessment of a neoadjuvant therapy in locally advanced and high risk prostate cancer before radical prostatectomy

Oncotarget ◽

10.18632/oncotarget.11653 ◽

2016 ◽

Vol 7 (39) ◽

pp. 63747-63757 ◽

Cited By ~ 3

Author(s):

Sarah M. Schwarzenböck ◽

Anna Knieling ◽

Michael Souvatzoglou ◽

Jens Kurth ◽

Katja Steiger ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Locally Advanced ◽

Therapy Response ◽

Response Assessment ◽

High Risk Prostate Cancer ◽

Pet Ct ◽

Risk Prostate Cancer ◽

Therapy Response Assessment

Download Full-text

18F-fluorocholine positron emission tomography-computed tomography (18F-FCH PET/CT) for staging of high-risk prostate cancer patients

Canadian Urological Association Journal ◽

10.5489/cuaj.5142 ◽

2018 ◽

Vol 13 (4) ◽

Cited By ~ 1

Author(s):

Simon Gauvin ◽

Alexis Rompré-Brodeur ◽

Guillaume Chaussé ◽

Maurice Anidjar ◽

Franck Bladou ◽

...

Keyword(s):

Prostate Cancer ◽

Computed Tomography ◽

High Risk ◽

Metastatic Disease ◽

Conventional Imaging ◽

Predictive Values ◽

High Risk Prostate Cancer ◽

Positron Emission ◽

Pet Ct ◽

Risk Prostate Cancer

Introduction: We sought to evaluate the diagnostic performance of 18F-fluorocholine positron emission tomography-computed tomography (18F-FCH PET/CT) for initial staging of patients with high-risk prostate cancer. Secondary objectives were to compare the value of 18F-FCH PET/CT to conventional imaging modalities and to evaluate its clinical impact. Methods: We conducted a retrospective study of 76 patients who underwent 18F-FCH PET/CT for initial staging of high-risk prostate cancer. Using pre-established validation criteria, sensitivity and specificity were determined for metastatic disease. Results were compared to findings on magnetic resonance imaging (MRI), computed tomography (CT), and bone scan (BS) when available. Results: Twenty-two (29%) PET/CT scans were positive, 49 (64%) negative, and five (7%) equivocal for nodal or metastatic disease. Of the positive scans, 17 showed regional lymph node involvement, 12 distant nodes, five bone metastases, and three lung metastases. Overall per-patient sensitivity, specificity, positive and negative predictive values for metastatic disease were 65%, 100%, 100%, and 78%, respectively. Sensitivity, specificity, and positive and negative predictive values were 64%, 100%, 100%, and 80%, respectively, for nodal involvement and 86%, 100%, 100%, and 98%, respectively, for bone and other metastases. Conventional imaging was negative for the lesion(s) found on PET/CT in five patients. PET/CT changed the clinical management in nine patients (12%). Conclusions: Although 18F-FCH PET/CT offers some benefits over conventional imaging and demonstrates a high specificity, it remains limited by its sensitivity in the context of high-risk prostate cancer staging. PET with novel urea-based small molecule prostate-specific membrane antigen (PSMA) inhibitors may overcome some of these limitations. However, the interpretation of the study result is limited by the lack of available histological gold standard, the inclusion of several patients who received androgen-deprivation therapy (ADT) prior to PET/CT, our retrospective design, and a relatively small sample size.

Download Full-text