Evidence map›Paper›PMID 40459584›Full record

ArticleWorld journal of urology2025

PSMA PET-detected mesorectal nodal metastasis: treatment outcomes and clinical implications.

Rashid K Sayyid, Zizo Al-Daqqaq, Shideh Abedi, Alexandra Gleave, Rui Bernardino, Raj Tiwari, Jessica Grace Cockburn, Ur Metser, Alejandro Berlin, Neil E Fleshner

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Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Rashid K SayyidCatherine and Joseph Aresty Department of Urology, University of Southern California, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA, 90089, USA. rksayyid@gmail.com.ORCID http://orcid.org/0000-0002-2133-569X
Zizo Al-DaqqaqTemerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Shideh AbediDivision of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Alexandra GleaveMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Rui BernardinoDivision of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Raj TiwariDepartment of Urology, Sengkang General Hospital, Singapore, Singapore.
Jessica Grace CockburnDivision of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Ur MetserJoint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.
Alejandro BerlinDepartment of Radiation Oncology, University of Toronto, Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Neil E FleshnerDivision of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the clinical significance of PSMA-PET/CT-detected mesorectal lymph node metastases in biochemically recurrent prostate cancer patients.

methodsThis is a retrospective analysis of biochemically recurrent prostate cancer patients (post-radical prostatectomy and/or radiotherapy) with a positive

resultsThe cohort included 301 patients with PSMA PET-positive disease, of whom 71 had mesorectal nodal disease (44 had mesorectal-only disease). At a median follow-up of 36 months, patients with mesorectal nodal-only disease had equivalent rates of castration resistance development, compared to patients with prostatic fossa-limited disease (HR = 0.99, p = 0.88). Sixteen patients with mesorectal nodal disease underwent metastasis-directed therapy. A PSA50 response was observed in 5/10 patients with mesorectal nodal-only disease and 2/6 for those with additional pelvic nodal disease. All patients without a PSA50 response were started on hormones, with no castrate-resistance development to date. The median hormone-free survival was 28 months.

conclusionsBiochemically recurrent patients with PSMA PET-detected mesorectal nodal disease have rates of castration-resistance development identical to those with prostatic fossa-limited disease and have promising clinical responses with metastasis-directed therapy. This suggests that such patients may potentially be spared upfront hormones and be considered for either surveillance or metastasis-directed therapy, in select circumstances.

Indexed as

Lymphatic MetastasisNeoplasm Recurrence, LocalPositron Emission Tomography Computed TomographyProstatic NeoplasmsAgedAntigens, SurfaceGlutamate Carboxypeptidase IIHumansMaleMiddle AgedRectumRetrospective StudiesTreatment OutcomeAntigens, SurfaceFOLH1 protein, humanGlutamate Carboxypeptidase IIBiochemical recurrenceCastrationCastration-resistantLymph nodesMesorectal lymph nodesMetastasis-directed therapyPositron-emission tomographyProstatic neoplasms

Identifiers

PMID40459584

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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.