PSMA PET predicts metastasis-free survival in the setting of salvage radiotherapy after radical prostatectomy
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PSMA PET predicts metastasis-free survival in the setting of salvage radiotherapy after radical prostatectomy. / Wenzel, Mike; Hussein, Rada; Maurer, Tobias; Karakiewicz, Pierre I; Tilki, Derya; Graefen, Markus; Würnschimmel, Christoph.
In: UROL ONCOL-SEMIN ORI, Vol. 40, No. 1, 01.2022, p. 7.e1-7.e8.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - PSMA PET predicts metastasis-free survival in the setting of salvage radiotherapy after radical prostatectomy
AU - Wenzel, Mike
AU - Hussein, Rada
AU - Maurer, Tobias
AU - Karakiewicz, Pierre I
AU - Tilki, Derya
AU - Graefen, Markus
AU - Würnschimmel, Christoph
N1 - Copyright © 2021 Elsevier Inc. All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - INTRODUCTION: To evaluate the impact of PSMA PET (prostate specific membrane antigen positron emission tomography) findings prior to salvage radiotherapy (SRT) in recurrent prostate cancer (PCa) after radical prostatectomy (RP) on metastasis-free survival (MFS).PATIENTS AND METHODS: Between 01/2012 and 12/2018, 1,599 patients received SRT for biochemical recurrence after RP at our institution. Five-year MFS of "positive PSMA PET" (n = 49) vs. "negative PSMA PET" (n = 106) vs. "no PSMA PET" (n = 1,599) prior to SRT was determined. For all time to event analyses, uni- and multivariable Cox's proportional hazards models and univariable Kaplan-Meier analyses were applied, with a significance threshold of P < 0.05. Further 4:1 propensity score matching for patient, cancer and treatment characteristics was performed to account for residual differences between groups.RESULTS: Of PSMA PET patients, 106 patients exhibited "negative PSMA PET" (68.4%) and 49 exhibited "positive PSMA PET" (31.6%). Median PSA at recurrence did not differ between groups (0.2 ng/ml; P= 0.4). After 4:1 propensity score matching, 5-year MFS between "no PSMA PET" and "negative PSMA PET" was 94.4 vs. 93.0%, respectively (P = 0.8). For "no PSMA PET" versus "positive PSMA PET", 5-year MFS was significantly lower in "positive PSMA PET" (92.3 vs. 48.5%, respectively P < 0.0001). Finally, "positive PSMA PET" was independently associated with worse MFS compared to "no PSMA PET" after multivariable adjustment in the overall cohort (HR 13.8, CI 7.5-25.2, P < 0.001).CONCLUSIONS: Locoregional positive PSMA PET findings in recurrent patients after RP are highly predictive of worse MFS in the setting of SRT.
AB - INTRODUCTION: To evaluate the impact of PSMA PET (prostate specific membrane antigen positron emission tomography) findings prior to salvage radiotherapy (SRT) in recurrent prostate cancer (PCa) after radical prostatectomy (RP) on metastasis-free survival (MFS).PATIENTS AND METHODS: Between 01/2012 and 12/2018, 1,599 patients received SRT for biochemical recurrence after RP at our institution. Five-year MFS of "positive PSMA PET" (n = 49) vs. "negative PSMA PET" (n = 106) vs. "no PSMA PET" (n = 1,599) prior to SRT was determined. For all time to event analyses, uni- and multivariable Cox's proportional hazards models and univariable Kaplan-Meier analyses were applied, with a significance threshold of P < 0.05. Further 4:1 propensity score matching for patient, cancer and treatment characteristics was performed to account for residual differences between groups.RESULTS: Of PSMA PET patients, 106 patients exhibited "negative PSMA PET" (68.4%) and 49 exhibited "positive PSMA PET" (31.6%). Median PSA at recurrence did not differ between groups (0.2 ng/ml; P= 0.4). After 4:1 propensity score matching, 5-year MFS between "no PSMA PET" and "negative PSMA PET" was 94.4 vs. 93.0%, respectively (P = 0.8). For "no PSMA PET" versus "positive PSMA PET", 5-year MFS was significantly lower in "positive PSMA PET" (92.3 vs. 48.5%, respectively P < 0.0001). Finally, "positive PSMA PET" was independently associated with worse MFS compared to "no PSMA PET" after multivariable adjustment in the overall cohort (HR 13.8, CI 7.5-25.2, P < 0.001).CONCLUSIONS: Locoregional positive PSMA PET findings in recurrent patients after RP are highly predictive of worse MFS in the setting of SRT.
U2 - 10.1016/j.urolonc.2021.06.008
DO - 10.1016/j.urolonc.2021.06.008
M3 - SCORING: Journal article
C2 - 34340868
VL - 40
SP - 7.e1-7.e8
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 1
ER -