Evidence map›Paper›PMID 33602654›Full record

ArticleEuropean urology oncology2022

Identifying the Best Candidates for Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography as the Primary Staging Approach Among Men with High-risk Prostate Cancer and Negative Conventional Imaging.

Ting Martin Ma, Andrei Gafita, David Shabsovich, Jesus Juarez, Tristan R Grogan, Pan Thin, Wesley Armstrong, Ida Sonni, Kathleen Nguyen, Vincent Lok and 16 more

2 registry-linked trialsOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03368547 nacompletednot on this map

68Ga-PSMA-11 PET/CT for Staging of Intermediate and High Risk Prostate Cancer Prior to Radical Prostatectomy

TypeinterventionalSponsorJonsson Comprehensive Cancer CenterRan2016 to 2021Enrolled400ConditionsProstate Adenocarcinoma, Stage IIB Prostate Cancer AJCC v7, Stage III Prostate Cancer AJCC v7, Stage IV Prostate Cancer AJCC v7ArmsComputed Tomography, Gallium Ga 68 Gozetotide, Positron Emission Tomography
NCT04050215 phase2completednot on this map

Impact of 68GA-PSMA-11 PET/CT on Initial and Subsequent Treatment Strategies of Patients With Prostate Cancer

TypeinterventionalSponsorJonsson Comprehensive Cancer CenterRan2018 to 2021Enrolled937ConditionsBiochemically Recurrent Prostate Carcinoma, Metastatic Prostate Carcinoma, Prostate Adenocarcinoma, Prostate CarcinomaArmsComputed Tomography, Gallium Ga 68-labeled PSMA-11, Positron Emission Tomography, Questionnaire Administration
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
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  6. Predictors ofJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2022
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  11. Diagnostic accuracy ofScience progress
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors at 5 institutions in 1 country.

Ting Martin MaDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
Andrei GafitaAhmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, CA, USA.
David ShabsovichDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
Jesus JuarezDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
Tristan R GroganStatistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Pan ThinAhmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, CA, USA.
Wesley ArmstrongAhmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, CA, USA.
Ida SonniAhmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, CA, USA.
Kathleen NguyenAhmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, CA, USA.
Vincent LokAhmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, CA, USA.
Robert E ReiterDepartment of Urology, UCLA Medical Center, Los Angeles, CA, USA.
Matthew B RettigDepartment of Urology, UCLA Medical Center, Los Angeles, CA, USA; Department of Medicine, Division of Hematology-Oncology, UCLA Medical Center, Los Angeles, CA, USA.
Michael L SteinbergDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
Patrick A KupelianDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
David D YangHarvard Radiation Oncology Program, Harvard Medical School, Boston, MA, USA.
Vinayak MuralidharHarvard Radiation Oncology Program, Harvard Medical School, Boston, MA, USA.
Carissa ChuDepartment of Urology, UCSF Medical Center, San Francisco, CA, USA.
Felix FengDepartment of Urology, UCSF Medical Center, San Francisco, CA, USA; Department of Radiation Oncology, UCSF Medical Center, San Francisco, CA, USA.
Ricky SavjaniDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
Jie DengDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
Neil R ParikhDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
Nicholas G NickolsDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA.
David ElashoffStatistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Johannes CzerninAhmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, CA, USA.
Jeremie CalaisAhmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, CA, USA.
Amar U KishanDepartment of Radiation Oncology, UCLA Medical Center, Los Angeles, CA, USA. Electronic address: aukishan@mednet.ucla.edu.
UCLA Medical Center · USRonald Reagan UCLA Medical Center · USHarvard University · USUniversity of California, Los Angeles · USUniversity of California San Francisco Medical Center · US

Funding

UCLA SPORE IN PROSTATE CANCERP50CA092131 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI REITER, ROBERT E · 2002 to 2023
$42.6M
UCLA SPORE in Brain CancerP50CA211015 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Yvonne Yu-Hsuan Chen · 2017 to 2026
$25.2M
NCI NIH HHS P50 CA092131NCI NIH HHS P50 CA211015
6 · The paper itself

Abstract

Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is an emerging imaging modality with greater sensitivity and specificity over conventional imaging for prostate cancer (PCa) staging. Using data from two prospective trials (NCT03368547 and NCT04050215), we explored predictors of overall upstaging (nodal and metastatic) by PSMA PET/CT among patients with cN0M0 National Comprehensive Cancer Network high-risk PCa on conventional imaging (n = 213). Overall, 21.1%, 8.9%, and 23.9% of patients experienced nodal, metastatic, and overall upstaging, respectively, without histologic confirmation. On multivariable analysis, Gleason grade group (GG) and percent positive core (PPC) on systematic biopsy significantly predict overall upstaging (odds ratio [OR] 2.15, 95% confidence interval [CI] 1.33-3.45; p =  0.002; and OR 1.03, 95% CI 1.01-1.04; p <  0.001). Overall upstaging was significantly more frequent among men with GG 5 disease (33.0% vs. 17.6%; p =  0.0097) and PPC ≥50% (33.0% vs 15.0%; p =  0.0020). We constructed a nomogram that predicts overall upstaging using initial prostate-specific antigen, PPC, GG, and cT stage, with coefficients estimated from a standard logistic regression model (using maximum likelihood estimation). It is internally validated with a tenfold cross-validated area under the receiver operating characteristic curve estimated at 0.74 (95% CI 0.67-0.82). In our cohort, 90% of patients who had a nomogram-estimated risk below the cutoff of 22% for overall upstaging could have been spared PSMA PET/CT as our model correctly predicted no upstaging. In other words, the predictive model only missed 10% of patients who would otherwise have benefitted from PSMA PET/CT. PATIENT SUMMARY: We analyzed predictors of overall upstaging (lymph node or/and metastasis) by prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) from conventional imaging in men with high-risk prostate cancer undergoing initial staging deemed free of disease in the lymph nodes and distant metastasis by conventional imaging techniques. We found that the pathologic grade and disease burden in a prostate biopsy are associated with upstaging. We also developed a tool that predicts the probability of upstaging according to an individual patient's characteristics. Our study may help in defining patient groups who are most likely to benefit from the addition of a PSMA PET/CT scan.

Indexed as

Positron Emission Tomography Computed TomographyProstatic NeoplasmsClinical Trials as TopicHumansMaleNomogramsProspective StudiesProstateConventional imagingGleason gradeNomogramOverall upstagingPercent positive corePositron emission tomography/computed tomographyProstate cancerProstate-specific membrane antigenStaging

Identifiers

PMID33602654
PMCPMC10262977
OpenAlexW3132948430

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.