-
Je něco špatně v tomto záznamu ?
Clinical parameters for the prediction of occult lymph node metastasis in patients with negative PSMA-PET
NA. Huebner, G. Wasinger, P. Rajwa, I. Resch, S. Korn, S. Rasul, P. Baltzer, L. Prüger, A. Rauschmeier, C. Seitz, E. Comperat, SF. Shariat, B. Grubmüller
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
- MeSH
- lidé MeSH
- lymfadenektomie MeSH
- lymfatické metastázy diagnostické zobrazování patologie MeSH
- lymfatické uzliny patologie MeSH
- nádory prostaty * patologie MeSH
- PET/CT metody MeSH
- radioizotopy galia * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Depending on the risk of LN metastasis ePLND at RP is recommended. As ePLND has potential side effects, and diagnostics have improved substantially, our objective was to evaluate the performance of the Briganti 2019 nomogram in a contemporary cohort with preoperative negative PSMA-PET. METHODS: Patients with intermediate- and high-risk prostate cancer (CaP), undergoing RP and ePND at our center with preoperative negative [68Ga]Ga-PSMA-11 PET were included. The Accuracy of the nomogram was assessed using ROC analysis. The association of clinical parameters with the presence of LN metastasis was assessed using logistic regression. Specimen of prostate and LNs in patients with false negative PSMA-PET were additionally stained for AR and PSMA expression and assessed by IHC. RESULTS: The study included 108 patients, 28% intermediate- and 72% high-risk. Twelve patients harbored occult LN metastasis. Accuracy of the nomogram was 0.62. [68Ga]Ga-PSMA-11 PET showed a NPV of 89%. IHC showed expression of PSMA and AR in the primary and LN metastasis in all patients. On logistic regression analysis only DRE (OR 2.72; 95%CI 1.01-7.35; P = 0.05) and percentage of cores with significant CaP (OR 1.29; 95%CI 1.05-1.60; P = 0.02) showed a significant association with LN metastasis. CONCLUSION: The currently used nomogram is suboptimal in detecting patients with occult LNM. While the cut-off value to perform ePLND can be increased slightly following a negative PSMA-PET scan, more accurate methods of identifying these patients are needed. Whether ePLND can have a therapeutic benefit, as opposed to a diagnostic only, needs to be re-evaluated in the PSMA-PET era.
Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Pathology Medical University of Vienna Vienna Austria
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Hospital Weinviertel Korneuburg Korneuburg Austria
Department of Urology Medical University of Silesia Zabrze Poland
Department of Urology Medical University of Vienna Vienna Austria
Department of Urology University of Texas Southwestern Dallas TX
Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman Jordan
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Working Group for Diagnostic imaging in Urology Vienna Austria
Citace poskytuje Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc24006576
- 003
- CZ-PrNML
- 005
- 20240423155351.0
- 007
- ta
- 008
- 240412s2024 xxu f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1016/j.urolonc.2023.12.016 $2 doi
- 035 __
- $a (PubMed)38246806
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a xxu
- 100 1_
- $a Huebner, Nicolai A $u Department of Urology, Medical University of Vienna, Vienna, Austria; Working Group for Diagnostic imaging in Urology (ABDU), Austrian Association of Urology (ÖGU), Vienna, Austria. Electronic address: Nicolai.huebner@meduniwien.ac.at
- 245 10
- $a Clinical parameters for the prediction of occult lymph node metastasis in patients with negative PSMA-PET / $c NA. Huebner, G. Wasinger, P. Rajwa, I. Resch, S. Korn, S. Rasul, P. Baltzer, L. Prüger, A. Rauschmeier, C. Seitz, E. Comperat, SF. Shariat, B. Grubmüller
- 520 9_
- $a BACKGROUND: Depending on the risk of LN metastasis ePLND at RP is recommended. As ePLND has potential side effects, and diagnostics have improved substantially, our objective was to evaluate the performance of the Briganti 2019 nomogram in a contemporary cohort with preoperative negative PSMA-PET. METHODS: Patients with intermediate- and high-risk prostate cancer (CaP), undergoing RP and ePND at our center with preoperative negative [68Ga]Ga-PSMA-11 PET were included. The Accuracy of the nomogram was assessed using ROC analysis. The association of clinical parameters with the presence of LN metastasis was assessed using logistic regression. Specimen of prostate and LNs in patients with false negative PSMA-PET were additionally stained for AR and PSMA expression and assessed by IHC. RESULTS: The study included 108 patients, 28% intermediate- and 72% high-risk. Twelve patients harbored occult LN metastasis. Accuracy of the nomogram was 0.62. [68Ga]Ga-PSMA-11 PET showed a NPV of 89%. IHC showed expression of PSMA and AR in the primary and LN metastasis in all patients. On logistic regression analysis only DRE (OR 2.72; 95%CI 1.01-7.35; P = 0.05) and percentage of cores with significant CaP (OR 1.29; 95%CI 1.05-1.60; P = 0.02) showed a significant association with LN metastasis. CONCLUSION: The currently used nomogram is suboptimal in detecting patients with occult LNM. While the cut-off value to perform ePLND can be increased slightly following a negative PSMA-PET scan, more accurate methods of identifying these patients are needed. Whether ePLND can have a therapeutic benefit, as opposed to a diagnostic only, needs to be re-evaluated in the PSMA-PET era.
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 _2
- $a lidé $7 D006801
- 650 12
- $a radioizotopy galia $7 D005710
- 650 _2
- $a lymfatické metastázy $x diagnostické zobrazování $x patologie $7 D008207
- 650 _2
- $a PET/CT $x metody $7 D000072078
- 650 12
- $a nádory prostaty $x patologie $7 D011471
- 650 _2
- $a lymfadenektomie $7 D008197
- 650 _2
- $a lymfatické uzliny $x patologie $7 D008198
- 655 _2
- $a časopisecké články $7 D016428
- 700 1_
- $a Wasinger, Gabriel $u Department of Pathology, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a Rajwa, Pawel $u Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
- 700 1_
- $a Resch, Irene $u Department of Urology, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a Korn, Stephan $u Department of Urology, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a Rasul, Sazan $u Department of Biomedical Imaging and Image guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a Baltzer, Pascal $u Department of Biomedical Imaging and Image guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a Prüger, Larissa $u Department of Urology, Hospital Weinviertel Korneuburg, Korneuburg, Austria
- 700 1_
- $a Rauschmeier, Andreas $u Department of Urology, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a Seitz, Christian $u Department of Urology, Medical University of Vienna, Vienna, Austria; Working Group for Diagnostic imaging in Urology (ABDU), Austrian Association of Urology (ÖGU), Vienna, Austria
- 700 1_
- $a Comperat, Eva $u Department of Pathology, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a Shariat, Shahrokh F $u Department of Urology, Medical University of Vienna, Vienna, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology and Division of Medical Oncology, Weill Medical College of Cornell University, New York, NY; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
- 700 1_
- $a Grubmüller, Bernhard $u Department of Urology and Andrology, University Hospital Krems, Karl Landsteiner University of Health Sciences, Krems, Austria
- 773 0_
- $w MED00008671 $t Urologic oncology $x 1873-2496 $g Roč. 42, č. 4 (2024), s. 115.e9-115.e16
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/38246806 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y - $z 0
- 990 __
- $a 20240412 $b ABA008
- 991 __
- $a 20240423155348 $b ABA008
- 999 __
- $a ok $b bmc $g 2080899 $s 1216343
- BAS __
- $a 3
- BAS __
- $a PreBMC-MEDLINE
- BMC __
- $a 2024 $b 42 $c 4 $d 115.e9-115.e16 $e 20240120 $i 1873-2496 $m Urologic oncology $n Urol Oncol $x MED00008671
- LZP __
- $a Pubmed-20240412