The relationship between local recurrences and distant metastases in prostate cancer: can11C-choline PET/CT contribute to understand the link?

G Giovacchini, A Ciarmiello, Elisabetta Giovannini, A Fodor, C Cozzarini, P Mapelli, E Incerti, N Di Muzio, L Gianolli, M Picchio

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Previous studies in prostate cancer (PCa) patients tried to correlate the onset of local recurrence (LR) with the development of distant metastases and formulated, based on theoretical and experimental data, hypotheses linking the two events. We aimed to address this issue with 11 C-choline positron emission tomography/computed tomography (PET/CT). Methods: This retrospective study included 491 PCa patients previously treated with radical prostatectomy who had undergone 11 C-choline PET/CT owing to biochemical failure. Further inclusion criteria were availability of clinical and pathological variables for survival analysis. Statistical significance was taken at P < 0.05. Results: Seventy-two patients (14.7%) had evidence of LR at 11 C-choline PET/CT. The frequency of LR increased from 13.8% in the interval 0–4 years after prostatectomy, to 23.9% in the 12–16-year interval (P = 0.080). On the contrary, the frequency of lymph node metastases (overall rate in the 0–16 years interval after prostatectomy: 26.3%) and of bone metastases (overall rate: 13.8%) decreased significantly over time. Kaplan-Meier curves showed no significant group difference in the rates of lymph node or bone metastases between patients with LR and patients without LR. LR significantly predicted PCa-specific survival at univariate analysis, but the statistical significance was lost at multivariate analysis. Conclusion: We found no differences in the rates of lymph node and bone metastases between patients with and without LR. An inverse time-dependent trend was observed in the frequency of LR on one side and of lymph node and bone metastases on the other side. These findings were discussed in relation to previous theories linking LR to distant metastases and our study design. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Original languageEnglish
Pages (from-to)962-969
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number6
DOIs
Publication statusPublished - 2018

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