Is 11C-choline Positron Emission Tomography/Computed Tomography Accurate to Detect Nodal Relapses of Prostate Cancer After Biochemical Recurrence? A Multicentric Study Based on Pathologic Confirmation from Salvage Lymphadenectomy

Oderda, Marco; Joniau, Steven; Palazzetti, Anna; Falcone, Marco; Melloni, Guglielmo; Bossche, Hannes Van Den; Deconinck, Steven; Zattoni, Fabio; Karnes, R. Jeffrey

doi:10.1016/j.euf.2015.12.004

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Preoperative imaging modalities were as previously described. 8 Surgical Procedure and Follow-Up Surgical dissection was not restricted to the PET/CT targeted area, but was extended to neighbouring regions according to surgical preference. Given the current unavailability of a recommended surgical template, no standardised surgical approach could be adopted.…”

Section: Methods Patient Populationmentioning

confidence: 99%

“…Data concerning PET/CT accuracy were previously reported. 8 Adjuvant and salvage therapies before sLND were adopted in a large number of patients. Nineteen patients (18%) already possessed CRPC status before undergoing sLND.…”

Section: Baseline Characteristics and Pathologic Outcomesmentioning

confidence: 99%

“…C-choline PET/CT, have allowed the identification of cases with oligometastatic nodal recurrence after radical therapy for PCa. 7,8 These are patients with presumed 'systemic' disease that is limited to the pelvic and/or retroperitoneal LNs. Traditionally, these these types of patients would have been referred to HRT, 5 being at increased risk of death from PCa.…”

Section: Univariable and Multivariable Cox Regression Models Predicti...mentioning

confidence: 99%

“…6 In this light, 11 C-choline positron emission tomography (PET)/computed tomography (CT) currently plays an essential role in the early detection of nodal metastases to correctly select patients suitable for sLND. 7,8 Previous studies have reported that although most patients inevitably progress to BCR after sLND, roughly 40% do not experience any further clinical recurrence (CR) even at long-term follow-up. 9,10 These are promising results; however, the feasibility of sLND in clinical practice remains limited by the lack of data concerning oncologic and surgical outcomes of this pioneering surgery.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Salvage Lymph Node Dissection for Prostate Cancer with Clinical Nodal Relapse: Results of a Multicentric, Retrospective Study

Oderda

Joniau²,

Melloni

et al. 2016

EMJ

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Introduction: Salvage lymph node dissection (sLND) is a treatment option for prostate cancer (PCa) patients with nodal recurrence after radical therapy to delay tumour progression and hormonal treatment. We evaluated the outcomes in terms of biochemical recurrence (BCR), clinical regression, and cancer specific survival (CSS) in a large, multicentric series of patients treated with sLND for nodal recurrence of PCa. Methods: We retrospectively reviewed the records of 106 consecutive patients with BCR of PCa after radical treatment who underwent sLND between 2007 and 2013 at three tertiary centres. BCR was defined as prostate-specific antigen (PSA) >0.2 ng/mL. Clinical recurrence (CR) was defined as a positive imaging study or biopsy for metastasis after sLND. Kaplan–Meier curves calculated BCR-free survival (BFS), CR-free survival (CRS), and CSS. Cox regression analyses were performed to identify predictors of CR. Results: Median number of nodes removed at sLND was 21.7, with a median of three positive nodes. Immediate biochemical response after surgery was achieved in 50.9% of patients. At a median follow-up of 22.5 months, biochemical failure and CR were experienced by 67.9% and 40.5% of patients, respectively. At 2 years, BFS, CRS, and CSS were 25%, 52%, and 92%, respectively. Castrate-resistant prostate cancer (CRPC) status, PSA level at sLND, and presence of biochemical failure after sLND were significantly associated with CR after surgery. Conclusions: sLND represents a valid treatment option for selected patients with nodal recurrences, achieving a CR-free status in more than half of patients at 2 years. Patients with CRPC status or high PSA values might not be the best candidates for a sLND.

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Section: Methods Patient Populationmentioning

confidence: 99%

Section: Baseline Characteristics and Pathologic Outcomesmentioning

confidence: 99%

Section: Univariable and Multivariable Cox Regression Models Predicti...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of Salvage Lymph Node Dissection for Prostate Cancer with Clinical Nodal Relapse: Results of a Multicentric, Retrospective Study

Oderda

Joniau²,

Melloni

et al. 2016

EMJ

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“…With a higher PSA value, shorter PSA doubling time, and higher Gleason score, the clinical yield of 68 Ga-PSMA PET/CT is greater [7]. In a high percentage of patients, lymph node metastases are found in atypical locations, even outside the template of extended pelvic lymphadenectomy [8]. In some reports, retrovesical PSMA activity has been described as mimicking lymph node metastasis [9].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Oncologic Outcome of Salvage Surgery in Isolated Seminal Vesicle Remnants after Radical Prostatectomy

et al. 2021

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Background: To demonstrate the feasibility of resecting isolated locally relapsing seminal vesicle remnants after primary radical prostatectomy and radiotherapy. Early oncologic outcomes and prognostic risk factors for relapse are demonstrated. Objectives and Methods: A total of 32 patients underwent open resection of locoregional prostate cancer recurrence in seminal vesicles, as documented on either MRI, 11C-choline, or 68Ga-PSMA PET/CT scans. Age, PSA-DT, PSA, and time to recurrence after primary treatment resection status were used in a uni- and multivariate Cox regression analysis for biochemical relapse after surgery. Results: Median patient age at time of salvage surgery was 70 (57–77) years. Median PSA and PSA-DT was 2.79 (0.4–61.54) ng/mL and 5.4 (1.6–20.1) months, respectively. Median surgical time and hospital stay was 132 (75–313) min and 5.5 (4–13) days, respectively. After a mean follow-up of 29 (2–92) months, 3 patients died at 8, 14, and 40 months after salvage surgery, and 6 (18.75%) patients remain without biochemical relapse and further treatment. Median progression-free survival was 12 (1–81) months. In the univariable Cox regression analysis, age at time of surgery, preoperative PSA, and the time from primary treatment to salvage surgery were identified as significant parameters for biochemical relapse. Only the interval from primary to salvage surgery was significant in the multivariate analysis with a hazard ratio of 1.008 (95% CI: 1.001–1.015, p = 0.018). In the entire cohort, 4 adjunctive surgeries (3 ureteroneocystostomies and 1 nephrectomy) were needed due to local progressive disease. Conclusion: Seminal vesicle resection is feasible with no significant intra- or postoperative complications. Almost all patients progressed to biochemical or systemic relapse. Salvage surgery must be seen as a preventive for local symptoms, in our experience most often postrenal ipsilateral obstruction.

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The Role of PET in Salvage Therapy for Prostate Cancer

Goonewardene

Persad

Albala³

et al. 2020

Salvage Therapy for Prostate Cancer

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Is 11C-choline Positron Emission Tomography/Computed Tomography Accurate to Detect Nodal Relapses of Prostate Cancer After Biochemical Recurrence? A Multicentric Study Based on Pathologic Confirmation from Salvage Lymphadenectomy

Cited by 8 publications

References 19 publications

Outcomes of Salvage Lymph Node Dissection for Prostate Cancer with Clinical Nodal Relapse: Results of a Multicentric, Retrospective Study

Outcomes of Salvage Lymph Node Dissection for Prostate Cancer with Clinical Nodal Relapse: Results of a Multicentric, Retrospective Study

Feasibility and Oncologic Outcome of Salvage Surgery in Isolated Seminal Vesicle Remnants after Radical Prostatectomy

The Role of PET in Salvage Therapy for Prostate Cancer

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