Detection rate, pattern of relapse and influence on therapeutic decision of PSMA PET/CT in patients affected by biochemical recurrence after radical prostatectomy, a retrospective case series

G Francolini, B Detti, M Bottero, T Zilli, A Lancia, A Bruni, S Borghesi, M Mariotti, P Castellucci, S Fanti, A R Filippi, M A Teriaca, V Maragna, C Aristei, E Mazzeo, L Livi, G Ingrosso

Research output: Contribution to journalArticlepeer-review

Abstract

AIMS: 68Ga-Prostate-specific membrane antigen (PSMA) PET/CT is widely used in patients with biochemical recurrence (BCR) after radical prostatectomy. We collected data about patients staged with PSMA PET/CT after BCR (PSA < 1 ng/ml) in four different institutes. Impact of baseline features (Gleason score, risk classification, PSA at recurrence, PSA doubling time and time to recurrence) was explored to understand predictive factors of (PSMA) PET/CT positivity. Impact of restaging on following treatment approaches was reported.

RESULTS: 92 patients were included. PSMA PET/CT detection rate was 56.5% and low-volume disease (≤ 3 non-visceral lesions) was detected in 52.2% of patients. After positive scan, 13.5% of patients still lies on observation, ADT alone was administered in 30.8% of cases, Stereotactic body RT (SBRT) alone was delivered to 44.2% of patients and 11.5% of patients underwent concomitant SBRT and ADT. Seven patients underwent conventional salvage prostate bed RT. Chi-squared test showed a higher rate of positive PSMA PET/CT for patients with Gleason score > 7 (p = 0.004) and TTR < 29.5 months (p = 0.003).

CONCLUSIONS: PSMA PET/CT showed a high detection rate. This influenced clinical management in a significant percentage of patients, allowing treatment tailoring on the basis of imaging.

Original languageEnglish
Pages (from-to)364-371
Number of pages8
JournalClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
Volume23
Issue number2
DOIs
Publication statusPublished - Feb 2021

Keywords

  • Aged
  • Androgen Antagonists/therapeutic use
  • Antigens, Surface
  • Gallium Isotopes
  • Gallium Radioisotopes
  • Glutamate Carboxypeptidase II
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Recurrence, Local/blood
  • Neoplasm Staging/methods
  • Positron Emission Tomography Computed Tomography
  • Prostate-Specific Antigen/blood
  • Prostatectomy
  • Prostatic Neoplasms/blood
  • Radiopharmaceuticals
  • Radiosurgery/statistics & numerical data
  • Radiotherapy/statistics & numerical data
  • Radiotherapy, Intensity-Modulated/statistics & numerical data
  • Retrospective Studies
  • Salvage Therapy/methods
  • Time Factors

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