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Titre : | Pre-surgical 68Ga-PSMA-11 PET for biochemical recurrence risk assessment: Follow-up analysis of a multicenter prospective phase 3 imaging trial [Compte rendu de Communication orale] (2023) |
Auteurs : | L. Djaileb ; W.R. Armstrong ; D. Thompson ; A. Gafita ; A. Farolfi ; T.R. Grogan ; W.P. Fendler ; J. Czernin ; T.A. Hope ; J. Calais |
Type de document : | Article |
Dans : | Médecine nucléaire (Vol. 47, n°2, mars 2023) |
Article en page(s) : | p. 50-51 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Prostate-Specific Membrane Antigen |
Mots-clés: | Pre-surgical PSMA PET ; Initial stagging ; Prognostic |
Résumé : |
Purpose/background
To assess the added prognostic value of pre-surgical PSMA PET for early biochemical recurrence (BCR) progression free-survival (BCR-PFS) compared to pre-surgical CAPRA (Cancer of the Prostate Risk Assessment) and post-surgical CAPRA-S scores in patients treated with radical prostatectomy (RP) and Pelvic Lymph Node Dissection (PLND) with intermediate-risk (IR) to high-risk (HR) prostate cancer (PCa). Methods This is a follow-up study of the surgery cohort included in the multicenter prospective phase 3 imaging trial (n =277; NCT03368547, NCT02611882, NCT02919111), which assessed the diagnostic accuracy of 68Ga-PSMA-11 PET for pelvic nodal metastasis detection prior to RP and PLND in patients with IR and HR PCa. Each PSMA-PET scan was read by three blinded independent readers. PSMA PET prostate uptake (low vs. high), PSMA PET extra-prostatic disease (N/M), CAPRA and CAPRA-S score were used to assess risk of BCR. Patients were followed up after RP by the local investigators using electronic medical records. BCR was defined by a prostate-specific antigen (PSA) level ≥ 0.2ng/mL after RP or an initiation of PCa specific secondary treatment (> 6 months after surgery). Univariate, multivariate Cox model, and c-statistic index were performed to assess the prognostic value of PSMA PET and to compare with CAPRA and CAPRA-S scores. Results From December 2015 to December 2019, a total of 277 patients underwent RP after PSMA-PET. Clinical follow-up was obtained in 240/277 (87%) patients. The median follow-up from surgery was 32.4 months. Ninety-one/240 BCR events (38%) were observed. PSMA extra-prostatic disease was found in 41/240 (17%) patients. PSMA PET high prostate uptake PSMA extra-prostatic disease, pre-surgical CAPRA score and post-surgical CAPRA-S score were significant univariate predictors of BCR. Only addition of PSMA extra-prostatic disease to CAPRA score significantly improved risk assessment compared to CAPRA score alone (c-statistic 0.70 (0.640.75) vs. 0.63 (0.570.69); P Conclusion Pre-surgical PSMA PET significantly improved early BCR-PFS risk assessment and presented an added prognostic value for pre-surgical CAPRA-score. The combination of PSMA PET and CAPRA score was not statistically different with the reference standard, i.e. the post-surgical CAPRA-S score. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.em-premium.com/revue/mednuc/47/2 |