• 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

. 2024 ; 42 (4) : 115.e9-115.e16. [pub] 20240120

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc24006576

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.

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

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...