ArticleBJUI compass2025
Anatomical distribution of disease in pN1 prostate cancer with BCR post-RP: A PSMA-PET/CT-based analysis.
Article in BJUI compass, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
The trial behind it
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Who cites it
1 citing paper in PubMed.
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: To explore the distribution of metastatic disease in pN1 patients with biochemical recurrence (BCR) assessed by Prostate-Specific Membrane Antigen-Positron-Emission/Computed Tomography (PSMA-PET/CT). Patients and Methods: This multicentre, retrospective cohort study included 130 pN1 PCa patients with BCR (PSA ≥ 0.2 ng/ml) post-RP with ePLND (2015-2022). All were preoperatively staged as molecular imaging (mi)N0M0 and underwent restaging PSMA-PET/CT at BCR. Clinical and imaging data were analysed using Mann-Whitney U, chi-square tests and Cox regression. Results: Median time to BCR was 9 months (IQR 3-18). Biochemical persistence (BCP) (PSA ≥ 0.1 ng/ml at first follow-up) occurred in 66/130 (51%). At restaging PSMA-PET/CT, median PSA was 0.33 ng/ml (IQR 0.24-0.65). PSMA-PET/CT identified metastases in 63/130 (48%), with 37/63 (59%) having lymph node metastases (LNMs) limited to the ePLND template - 16/37 (43%) on the ipsilateral side of the positive resected node. Additionally, 26/63 (41%) had disease beyond the nodal template (miM+). Univariate Cox regression identified BCP as a predictor for any PSMA-PET/CT-detected recurrence, while a higher ISUP grade group at RP predicted miM+ disease. Conclusion: PSMA-PET/CT identified PSMA-expressing recurrent disease in nearly half of pN1 PCa patients at early BCR, with about half confined to the pelvis and a quarter beyond the pelvis. These anatomical patterns indicate that PSMA-PET/CT can inform risk-adapted salvage strategies, including pelvic radiotherapy for nodal recurrences and systemic treatment when disease extends beyond the pelvis.
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