常规68Ga-PSMA-11 PET/CT对新诊断的前列腺癌患者的临床后果,ISUP 5级,根据标准影像学无转移-初步结果

IF 1.4 4区 医学 Q3 UROLOGY & NEPHROLOGY
Helle D Zacho, Surenth Nalliah, Astrid Petersen, Lars J Petersen
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引用次数: 1

摘要

目的:评估前列腺特异性膜抗原(PSMA) PET/CT对ISUP 5级(Gleason评分≥9)前列腺癌(PCa)患者初级分期的临床影响,根据标准影像学无明确的远处转移。方法:在我们的机构转诊中心,PSMA PET/CT从2018年8月起成为前列腺癌初级分期的标准护理标准,给出以下标准:(1)无前列腺癌治疗史,(2)ISUP 5级,(3)标准影像学(增强CT和骨显像)无明确转移,(4)根据合并症和预期寿命认为适合治疗。我们介绍了前6个月招募和12个月随访的初步结果。结果:纳入48例患者(平均年龄69岁,中位PSA 13.0 ng/mL,局部晚期PCa患者20例)。2例患者盆腔淋巴结CT阳性,3例患者骨显像不明确。PSMA PET/CT显示前列腺床外病变22例(46%),其中13例(27%)表现为局限于区域淋巴结,9例(19%)表现为非区域淋巴结转移和/或骨转移。PSMA PET/CT将18例(38%)患者的治疗策略从治愈性治疗改为姑息性治疗。结论:PMSA PET/CT显示,在标准影像学上没有明确转移的高危患者中,有很大一部分在初级阶段出现了病理性摄取,导致38%的患者改变了治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The clinical consequences of routine 68Ga-PSMA-11 PET/CT in patients with newly diagnosed prostate cancer, ISUP grade 5 and no metastases based on standard imaging - preliminary results.

Aim: To evaluate the clinical consequences of prostate specific membrane antigen (PSMA) PET/CT for primary staging in patients with ISUP grade 5 (Gleason score ≥9) prostate cancer (PCa), and no definitive distant metastases based on standard imaging.

Methods: At our tertial referral center, PSMA PET/CT became standard of care from August 2018 for primary staging of prostate cancer given the following criteria: (1) no prior treatment for prostate cancer, (2) ISUP grade 5, (3) no definitive metastases on standard imaging (contrast enhanced CT and bone scintigraphy), and (4) deemed suitable for treatment with curative intent based on comorbidity and life expectancy. We present the preliminary results of first six months recruitment with 12 months of follow-up.

Results: Forty-eight patients (mean age 69 years, median PSA 13.0 ng/mL, 20 patients with locally advanced PCa) were included. CT was positive in pelvic lymph nodes in two patients, bone scintigraphy was equivocal in three patients. PSMA PET/CT showed pathological uptake outside the prostatic bed in 22 patients (46%) of which 13 patients (27%) showed lesions confined to regional lymph nodes, and nine patients (19%) showed nonregional lymph node metastases and/or bone metastases. PSMA PET/CT changed the treatment strategy from curatively intended treatment to palliative treatment in 18 patients (38%).

Conclusion: PMSA PET/CT revealed pathological uptake in a large proportion of high-risk patients at primary staging among patients with no definite metastases on standard imaging leading to change of patient management in 38% of the patients.

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来源期刊
Scandinavian Journal of Urology
Scandinavian Journal of Urology UROLOGY & NEPHROLOGY-
CiteScore
2.90
自引率
6.70%
发文量
70
期刊介绍: Scandinavian Journal of Urology is a journal for the clinical urologist and publishes papers within all fields in clinical urology. Experimental papers related to clinical questions are also invited.Important reports with great news value are published promptly.
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