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Hijazi, S; Meller, B; Leitsmann, C; Strauss, A; Meller, J; Ritter, CO; Lotz, J; Schildhaus, HU; Trojan, L; Sahlmann, CO.
Pelvic lymph node dissection for nodal oligometastatic prostate cancer detected by 68Ga-PSMA-positron emission tomography/computerized tomography.
Prostate. 2015; 75(16): 1934-40.
Doi: 10.1002/pros.23091
Web of Science
PubMed
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FullText_MUG
- Co-authors Med Uni Graz
- Leitsmann Conrad
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- Abstract:
- BACKGROUND: The first evaluation of pelvic extended lymph node dissection (pLND) in oligometastatic prostate cancer (PCa) detected by (68)Ga-PSMA PET/CT. METHODS: Retrospective analysis of 35 PCa patients underwent (68)Ga-PSMA PET/CT affected by biochemical recurrence (BCR) after curative treatment (n = 23) or before primary therapy of high-risk PCa (n = 12). We performed pLND associated with pathologic imaging in 17 men with nodal oligometastatic PCa. RESULTS: Indicative lesions for PCa in PET/CT were detected in 91.4% (32 of 35) of patients. Nodal, bone, visceral (pulmonary), and within the prostate suspected disease were detected in 72% (23 of 32), 16% (5 of 32), 6% (2 of 32), and 47% (15 of 32) of patients, respectively. Median serum PSA in patients with pathological radiotracer uptake in recurrent and high-risk PCa patients was 2.9 ng/ml (range 0.18-30) and 19.5 ng/ml (range 6-90), respectively. The median number of removed lymph nodes with pLND in recurrent and high-risk PCa was 10 (range 4-17) and 12 (range 8-29) per patient and the median number of positive lymph nodes was 1 (range 1-2) and 3 (2-3) per patient, respectively. In total, two false positive and one false-negative lymph node were found. Diagnostic accuracies per nodal lesion in total of 213 removed nodes: sensitivity, 94%; specificity, 99%; positive predictive value (PPV), 89%, and negative predictive value (NPV), 99.5%. After pLND, 53% (9 of 17) of patients received androgen deprivation therapy and/or radiation therapy and hormonal therapy, while 47% (8 of 17) of patients remained free of any post-surgery therapy. Follow-up PSA remained less than 0.2 ng/ml in 82% (14 of 17) of patients. After pLND, immediate BCR (PSA never measured less than 0.2 ng/ml) in 18% (3 of 17) of patients was recorded. CONCLUSIONS: This represents the first study of pLND in the setting of nodal oligometastatic PCa detected by (68)Ga-PSMA PET/CT. The use of (68)Ga-PSMA PET/CT could be to improve the accuracy for the detection of nodal micrometastases. These promising findings need validation in larger studies.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Humans - administration & dosage
- Lymph Node Excision - administration & dosage
- Lymphatic Metastasis - diagnostic imaging, pathology
- Male - administration & dosage
- Middle Aged - administration & dosage
- Multimodal Imaging - administration & dosage
- Positron-Emission Tomography - administration & dosage
- Predictive Value of Tests - administration & dosage
- Prostatectomy - administration & dosage
- Prostatic Neoplasms - diagnostic imaging, pathology, surgery
- Retrospective Studies - administration & dosage
- Sensitivity and Specificity - administration & dosage
- Find related publications in this database (Keywords)
- prostate cancer
- biochemical recurrence
- Ga-68-PSMA PET
- CT
- PSMA
- pelvic lymph node dissection