The relevance of nomograms for prediction of pelvic lymph node metastases in the prostate-specific membrane antigen (PSMA)-PET/CT era.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 3/4)
유사 논문P · Population 대상 환자/모집단
70 patients underwent RP for intermediate (34 patients) or high-risk disease (36 patients).
I · Intervention 중재 / 시술
RP with PLND and were followed postoperatively for at least 6 months
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSIONS] Preoperative PSMA-PET/CT with no extraprostatic uptake before RP in patients with intermediate to high-grade PC is highly accurate for ruling out LN involvement, superior to the routinely used nomograms. Its use induced stage migration, rendering predictive nomograms irrelevant.
[BACKGROUND/AIMS] Current guidelines suggest that the indications for pelvic lymph node (LN) dissection (PLND) during radical prostatectomy (RP) should rely on nomograms predicting their involvement.
APA
Gofrit ON, Orevi M, et al. (2025). The relevance of nomograms for prediction of pelvic lymph node metastases in the prostate-specific membrane antigen (PSMA)-PET/CT era.. Current urology, 19(5), 353-356. https://doi.org/10.1097/CU9.0000000000000290
MLA
Gofrit ON, et al.. "The relevance of nomograms for prediction of pelvic lymph node metastases in the prostate-specific membrane antigen (PSMA)-PET/CT era.." Current urology, vol. 19, no. 5, 2025, pp. 353-356.
PMID
40894280
Abstract
[BACKGROUND/AIMS] Current guidelines suggest that the indications for pelvic lymph node (LN) dissection (PLND) during radical prostatectomy (RP) should rely on nomograms predicting their involvement. Positron emission tomography/computed tomography (PET/CT) with prostate-specific membrane antigen (PSMA) radioligand is gaining acceptance as routine diagnostic test before RP in patients with intermediate/high-risk prostate cancer (PC). In this study, we examined the effect of preoperative PET/CT on the accuracy of the nomograms.
[MATERIALS AND METHODS] Patients with intermediate/high risk PC showing no extraprostatic disease on PET/CT-PSMA underwent RP with PLND and were followed postoperatively for at least 6 months. Patients with detectable (>0.1 ng/mL) postoperative prostate-specific antigen levels underwent re-evaluation with PET/CT-PSMA.
[RESULTS] A total of 70 patients underwent RP for intermediate (34 patients) or high-risk disease (36 patients). According to the Partin, MSKCC, and Briganti 2012 nomograms, positive LNs were expected in 7, 13, and 12 patients, respectively. At PLND, 1 positive LN was found in a single patient ( < 0.05 compared with the expected number of patients from all nomograms). Postoperatively, 10 patients developed detectable prostate-specific antigen levels. One patient exhibited radioligand uptake that could indicate LN involvement. Considering these 2 patients as failures, the negative predictive value of PSMA-PET/CT for LN involvement was 97.1%.
[CONCLUSIONS] Preoperative PSMA-PET/CT with no extraprostatic uptake before RP in patients with intermediate to high-grade PC is highly accurate for ruling out LN involvement, superior to the routinely used nomograms. Its use induced stage migration, rendering predictive nomograms irrelevant.
[MATERIALS AND METHODS] Patients with intermediate/high risk PC showing no extraprostatic disease on PET/CT-PSMA underwent RP with PLND and were followed postoperatively for at least 6 months. Patients with detectable (>0.1 ng/mL) postoperative prostate-specific antigen levels underwent re-evaluation with PET/CT-PSMA.
[RESULTS] A total of 70 patients underwent RP for intermediate (34 patients) or high-risk disease (36 patients). According to the Partin, MSKCC, and Briganti 2012 nomograms, positive LNs were expected in 7, 13, and 12 patients, respectively. At PLND, 1 positive LN was found in a single patient ( < 0.05 compared with the expected number of patients from all nomograms). Postoperatively, 10 patients developed detectable prostate-specific antigen levels. One patient exhibited radioligand uptake that could indicate LN involvement. Considering these 2 patients as failures, the negative predictive value of PSMA-PET/CT for LN involvement was 97.1%.
[CONCLUSIONS] Preoperative PSMA-PET/CT with no extraprostatic uptake before RP in patients with intermediate to high-grade PC is highly accurate for ruling out LN involvement, superior to the routinely used nomograms. Its use induced stage migration, rendering predictive nomograms irrelevant.