Peering through the PSMA PET Lens: The Role of the European Association of Urology Biochemical Recurrence Risk Groups after Radical Prostatectomy

(1) Background: The European Association of Urology (EAU) biochemical recurrence (BCR) risk grouping relies on data from historical cohorts that used conventional imaging techniques. In the era of PSMA PET/CT, we compared the patterns of positivity in the two risk groups and provided insight into po...

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Bibliographic Details
Published in:Cancers 2023-05, Vol.15 (11), p.2926
Main Authors: Leplat, Charles, Jabbour, Teddy, Diamand, Romain, Baudewyns, Arthur, Bourgeno, Henri Alexandre, Shagera, Qaid Ahmed, Flamen, Patrick, Roumeguere, Thierry, Peltier, Alexandre, Artigas, Carlos
Format: Article
Language:English
Subjects:
Androgens
Cancer therapies
Care and treatment
Classification
Computed tomography
Medical imaging
Medical prognosis
Medical research
Medicine, Experimental
Metastases
Metastasis
Nuclear medicine
Patients
PET imaging
Prostate cancer
Prostatectomy
Risk groups
Statistical analysis
Surgery
Tomography
Urology
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Summary:(1) Background: The European Association of Urology (EAU) biochemical recurrence (BCR) risk grouping relies on data from historical cohorts that used conventional imaging techniques. In the era of PSMA PET/CT, we compared the patterns of positivity in the two risk groups and provided insight into positivity predictive factors. (2) Methods: Data from 1185 patients who underwent Ga-PSMA-11PET/CT for BCR was analyzed, out of which 435 patients treated initially treated by radical prostatectomy were included in the final analysis. (3) Results: A significantly higher rate of positivity in the BCR high-risk group was observed (59% vs. 36%, < 0.001). BCR low-risk group demonstrated more local (26% vs. 6%, < 0.001) and oligometastatic (100% vs. 81%, < 0.001) recurrences. The BCR risk group and PSA level at the time of PSMA PET/CT were independent predictive factors of positivity. (4) Conclusions: This study confirms that the EAU BCR risk groups have different rates of PSMA PET/CT positivity. Even with a lower rate in the BCR low-risk group, oligometastatic disease was 100% in those with distant metastases. Given the presence of discordant positivity and risk classification, integrating PSMA PET/CT positivity predictors into risk calculators for BCR might improve patient classification for subsequent treatment options. Future prospective studies are still needed to validate the above findings and assumptions.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15112926