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2. Middellangetermijnoverleving na open versus robotgeassisteerde radicale cystectomie in Nederland: resultaten van de ‘SNAPSHOT’ cystectomie

Author

van Ginkel, Noor, Vis, André N., Boormans, Joost L., van der Poel, Henk G., van der Schoot, Deric K. E., Aben, Katja K. H., Hermans, Tom J. N., Meijer, Dennie, Voortman, Jens, Arends, Tom J. H., Ausems, Peter J., Baselmans, Dorine, Berger, Christian P. A. M., Berrens, Anne-Claire, Bickerstaffe, Henry, Bos, Siebe D., Braam, Marlene, Buddingh, K. Tim, Claus, Sebastiaan, Dekker, Karen, van Doeveren, Thomas, Einerhand, Sarah M. H., Fossion, Laurent M. C. Laurent, Hinsenveld, Florentien J., van Gennep, Erik J., Grondhuis Palacios, Lorena A., Hobijn, Mandy M., van Huystee, Suzanne H., Jaspers-Valentijn, Martinique, Klaver, O. Sjoerd, Koldewijn, Evert L., Korsten, Linn, Lenting, Anne, Lentjes, Koen J., Luiting, Henk B., van der Meer, Saskia, Mertens, Laura, Nieuwenhuijzen, Jakko A., Noordzij, M. Arjen, Nooter, Ronald I., Notenboom, Marije, Oomen, Robert J. A., van Roermund, Joep G. H., de Rooij, Judith, Roshani, Hossain, Schrier, Bart P., van der Slot, Michelle A., Somford, D. M. Rik, Stelwagen, Piter-Jan, Stroux, Aukje M. A., van der West, Alwine, Wijsman, Bart P., Windt, Willemijn A. K. M., van Zanten, Paul, and van Beek, Sytse C.

Published
2023
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7. Intermediate term survival following open versus robot-assisted radical cystectomy in the Netherlands: results of the Cystectomie SNAPSHOT study

Author

van Ginkel, Noor, primary, Vis, André N., additional, Boormans, Joost L., additional, van der Poel, Henk G., additional, van der Schoot, Deric K. E., additional, Aben, Katja K. H., additional, Hermans, Tom J. N., additional, Meijer, Dennie, additional, Voortman, Jens, additional, Arends, Tom J. H., additional, Ausems, Peter J., additional, Baselmans, Dorine, additional, Berger, Christian P. A. M., additional, Berrens, Anne-Claire, additional, Bickerstaffe, Henry, additional, Bos, Siebe D., additional, Braam, Marlene, additional, Buddingh, K. Tim, additional, Claus, Sebastiaan, additional, Dekker, Karen, additional, van Doeveren, Thomas, additional, Einerhand, Sarah M. H., additional, Fossion, Laurent M. C. Laurent, additional, Hinsenveld, Florentien J., additional, van Gennep, Erik J., additional, Grondhuis Palacios, Lorena A., additional, Hobijn, Mandy M., additional, van Huystee, Suzanne H., additional, Jaspers-Valentijn, Martinique, additional, Klaver, O. Sjoerd, additional, Koldewijn, Evert L., additional, Korsten, Linn, additional, Lenting, Anne, additional, Lentjes, Koen J., additional, Luiting, Henk B., additional, van der Meer, Saskia, additional, Mertens, Laura, additional, Nieuwenhuijzen, Jakko A., additional, Noordzij, M. Arjen, additional, Nooter, Ronald I., additional, Notenboom, Marije, additional, Oomen, Robert J. A., additional, van Roermund, Joep G. H., additional, de Rooij, Judith, additional, Roshani, Hossain, additional, Schrier, Bart P., additional, van der Slot, Michelle A., additional, Somford, D. M. Rik, additional, Stelwagen, Piter-Jan, additional, Stroux, Aukje M. A., additional, van der West, Alwine, additional, Wijsman, Bart P., additional, Windt, Willemijn A. K. M., additional, van Zanten, Paul, additional, and van Beek, Sytse C., additional

Published
2023
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11. Middellangetermijnoverleving na open versus robotgeassisteerde radicale cystectomie in Nederland:resultaten van de ‘SNAPSHOT’ cystectomie

Author

van Ginkel, Noor, Vis, André N., Boormans, Joost L., van der Poel, Henk G., van der Schoot, Deric K.E., Aben, Katja K.H., Hermans, Tom J.N., Meijer, Dennie, Voortman, Jens, Arends, Tom J.H., Ausems, Peter J., Baselmans, Dorine, Berger, Christian P.A.M., Berrens, Anne Claire, Bickerstaffe, Henry, Bos, Siebe D., Braam, Marlene, Buddingh, K. Tim, Claus, Sebastiaan, Dekker, Karen, van Doeveren, Thomas, Einerhand, Sarah M.H., Fossion, Laurent M.C.Laurent, Hinsenveld, Florentien J., van Gennep, Erik J., Grondhuis Palacios, Lorena A., Hobijn, Mandy M., van Huystee, Suzanne H., Jaspers-Valentijn, Martinique, Klaver, O. Sjoerd, Koldewijn, Evert L., Korsten, Linn, Lenting, Anne, Lentjes, Koen J., Luiting, Henk B., van der Meer, Saskia, Mertens, Laura, Nieuwenhuijzen, Jakko A., Noordzij, M. Arjen, Nooter, Ronald I., Notenboom, Marije, Oomen, Robert J.A., van Roermund, Joep G.H., de Rooij, Judith, Roshani, Hossain, Schrier, Bart P., van der Slot, Michelle A., Somford, D. M.Rik, Stelwagen, Piter Jan, Stroux, Aukje M.A., van der West, Alwine, Wijsman, Bart P., Windt, Willemijn A.K.M., van Zanten, Paul, van Beek, Sytse C., van Ginkel, Noor, Vis, André N., Boormans, Joost L., van der Poel, Henk G., van der Schoot, Deric K.E., Aben, Katja K.H., Hermans, Tom J.N., Meijer, Dennie, Voortman, Jens, Arends, Tom J.H., Ausems, Peter J., Baselmans, Dorine, Berger, Christian P.A.M., Berrens, Anne Claire, Bickerstaffe, Henry, Bos, Siebe D., Braam, Marlene, Buddingh, K. Tim, Claus, Sebastiaan, Dekker, Karen, van Doeveren, Thomas, Einerhand, Sarah M.H., Fossion, Laurent M.C.Laurent, Hinsenveld, Florentien J., van Gennep, Erik J., Grondhuis Palacios, Lorena A., Hobijn, Mandy M., van Huystee, Suzanne H., Jaspers-Valentijn, Martinique, Klaver, O. Sjoerd, Koldewijn, Evert L., Korsten, Linn, Lenting, Anne, Lentjes, Koen J., Luiting, Henk B., van der Meer, Saskia, Mertens, Laura, Nieuwenhuijzen, Jakko A., Noordzij, M. Arjen, Nooter, Ronald I., Notenboom, Marije, Oomen, Robert J.A., van Roermund, Joep G.H., de Rooij, Judith, Roshani, Hossain, Schrier, Bart P., van der Slot, Michelle A., Somford, D. M.Rik, Stelwagen, Piter Jan, Stroux, Aukje M.A., van der West, Alwine, Wijsman, Bart P., Windt, Willemijn A.K.M., van Zanten, Paul, and van Beek, Sytse C.

Abstract

There is insufficient knowledge on intermediate-term survival of non-metastatic muscle-invasive bladder cancer (MIBC) after open (ORC) versus robot-assisted (RARC) cystectomy, with or without neo-adjuvant chemotherapy (NAC). This retrospective study was performed in 19 Dutch hospitals between 2012 and 2015 to assess the five-year survival after both interventions and the influence of NAC. Out of 1,534 cT1-4N0-1-patients, 1,086 patients were treated with ORC and 389 with RARC. The 5‑year survival rate after ORC was 51% (95% CI 47–53) versus 58% after RARC (95% CI 52–63), hazard ratio 1.00 (95% CI 0.84–1.20) after multivariable analysis. 226 of 965 cT2-4aN0 patients were treated with NAC. More patients had ypT0 after NAC than after no NAC (31% vs 15%; p < 0.01). The best five-year survival was in patients with ypT0 after NAC (89%; 95% CI 81–97). This study shows similar five-year survival of MIBC patients treated with ORC or RARC and shows that the best survival was after NAC.

Published
2023

12. Active Surveillance for Prostate Cancer:Past, Current, and Future Trends

Author

de Vos, Ivo I., Luiting, Henk B., Roobol, Monique J., de Vos, Ivo I., Luiting, Henk B., and Roobol, Monique J.

Abstract

In response to the rising incidence of indolent, low-risk prostate cancer (PCa) due to increased prostate-specific antigen (PSA) screening in the 1990s, active surveillance (AS) emerged as a treatment modality to combat overtreatment by delaying or avoiding unnecessary definitive treatment and its associated morbidity. AS consists of regular monitoring of PSA levels, digital rectal exams, medical imaging, and prostate biopsies, so that definitive treatment is only offered when deemed necessary. This paper provides a narrative review of the evolution of AS since its inception and an overview of its current landscape and challenges. Although AS was initially only performed in a study setting, numerous studies have provided evidence for the safety and efficacy of AS which has led guidelines to recommend it as a treatment option for patients with low-risk PCa. For intermediate-risk disease, AS appears to be a viable option for those with favourable clinical characteristics. Over the years, the inclusion criteria, follow-up schedule and triggers for definitive treatment have evolved based on the results of various large AS cohorts. Given the burdensome nature of repeat biopsies, risk-based dynamic monitoring may further reduce overtreatment by avoiding repeat biopsies in selected patients.

Published
2023

13. Interaction of MRI and active surveillance in prostate cancer:Time to re-evaluate the active surveillance inclusion criteria

Author

Venderbos, Lionne DF, Luiting, Henk, Hogenhout, Renée, Roobol, Monique J., Venderbos, Lionne DF, Luiting, Henk, Hogenhout, Renée, and Roobol, Monique J.

Abstract

Currently available data from long-running single- and multi-center active surveillance (AS) studies show that AS has excellent cancer-specific survival rates. For AS to be effective the ‘right’ patients should be selected for which up until 5-to-10 years ago systematic prostate biopsies were used. Because the systematic prostate strategy relies on sampling efficiency for the detection of prostate cancer (PCa), it is subject to sampling error. Due to this sampling error, many of the Gleason 3+3 PCas that were included on AS in the early days and were classified as low-risk, may in fact have had a higher Gleason score. Subsequently, AS-criteria were more strict to overcome or limit the number of men missing the potential window of curability in case their tumor would be reclassified. Five to ten years ago the prostate biopsy landscape changed drastically by the addition of magnetic resonance imaging (MRI) into the diagnostic PCa-care pathway, which has by now trickled down into the EAU guidelines. At the moment, the EAU guidelines recommend performing a (multi-parametric) MRI before prostate biopsy and combine systematic and targeted prostate biopsy when the MRI is positive (i.e. PIRADS ≥3). So because of the introduction of the MRI into the diagnostic PCa-care pathway, literature is showing that more Gleason 3+4 PCas are being diagnosed. But can it not be that the inclusion of MRI into the diagnostic PCa-care pathway causes risk inflation, resulting in men earlier eligible for AS, now being labelled ineligible for AS? Would it not be possible to include these current Gleason 3+4 PCas on AS? The authors hypothesize that the improved accuracy that comes with the introduction of MRI into the diagnostic PCa-care pathway permits to widen both the AS-inclusion and follow-up criteria. Maintaining our inclusion criteria for AS from the systematic biopsy era will unnecessarily and undesirably expose patients to the increased risk of overtreatment. The evidence behind the

Published
2023

15. Predictive Value of Cribriform and Intraductal Carcinoma for the Nomogram-based Selection of Prostate Cancer Patients for Pelvic Lymph Node Dissection

Author

de Barros, Hilda A., primary, Remmers, Sebastiaan, additional, Luiting, Henk B., additional, van Leenders, Geert J.L.H., additional, Roobol, Monique J., additional, Bekers, Elise M., additional, Amin, Amer, additional, Haynes, Anne-Maree, additional, Delprado, Warick, additional, Stricker, Phillip D., additional, van der Poel, Henk G., additional, van der Kwast, Theodorus H., additional, and van Leeuwen, Pim J., additional

Published
2022
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17. MP43-05 UPFRONT MRI IS THE NEW STANDARD, HAVE CONFIRMATORY BIOPSIES BECOME OBSOLETE?

Author

Luiting, Henk, primary, de Vos, Ivo Izaak, additional, Remmers, Sebastiaan, additional, Boevé, Egbert, additional, Bangma, Chris, additional, Valdagni, Riccardo, additional, Chiu, Peter, additional, Semjonow, Axel, additional, Berge, Viktor, additional, Tully, Karl, additional, Rannikko, Antti, additional, Staerman, Frédéric, additional, and Roobol, Monique, additional

Published
2022
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22. External Validation of Two Nomograms Developed for 68Ga-PSMA-11 Applied to the Prostate-specific Membrane Antigen Tracer 18F-DCFPyl:Is Prediction of the Optimal Timing of Salvage Therapy Feasible?

Author

Luiting, Henk B., Remmers, Sebastiaan, Meijer, Dennie, Vis, André N., Donswijk, Maarten, Oprea-Lager, Daniela E., Emmett, Louise, Rauscher, Isabel, Van der Poel, Henk G., Roobol, Monique J., van Leeuwen, Pim J., Luiting, Henk B., Remmers, Sebastiaan, Meijer, Dennie, Vis, André N., Donswijk, Maarten, Oprea-Lager, Daniela E., Emmett, Louise, Rauscher, Isabel, Van der Poel, Henk G., Roobol, Monique J., and van Leeuwen, Pim J.

Abstract

Two nomograms have been developed to predict the outcome of positron emission tomography (PET)/computed tomography (CT) imaging with68Ga-labeled ligands for prostate-specific membrane antigen (68Ga-PSMA) for patients with rising prostate-specific antigen after radical prostatectomy (RP). These nomograms quantify the ability of PSMA PET/CT to detect prostate cancer recurrences, and therefore provide critical information in determining the optimal timing for PSMA PET/CT in guiding salvage therapies. We validated the ability of these nomograms to accurately predict PET/CT outcome using another ligand tracer, 18F-DCFPyL. The external validation cohort consisted of 157 men from the Prostate Cancer Network Netherlands who underwent 18F-DCFPyL PET/CT to guide salvage therapies after RP. The nomogram of Rauscher et al (predicting a positive scan) showed accurate prediction of 50–80% (discrimination 0.68, 95% confidence interval [CI] 0.59–0.76). The nomogram of Luiting et al (predicting recurrence outside the prostatic fossa) showed accurate prediction for predicted probability values between 15% and 65%, with a small degree of overestimation for predicted probability values between 30% and 50% (discrimination 0.74, 95% CI 0.28–1.24). According to calibration curves, discrimination results, and decision curve analysis, we conclude that clinicians can use these 68Ga-PSMA–based nomograms to predict 18F-DCFPyL PET/CT outcome. These nomograms improve shared decision-making in determining the optimal time to initiate PSMA PET/CT–guided salvage therapies. Patient summary: Prediction tools developed for prostate scans (positron emission tomography, PET) using one type of radioactive tracer (chemicals labeled with gallium-68) are also accurate in predicting scan findings with another tracer (a chemical labeled with fluorine-18). Our study confirms that these tools can be used to guide decisions on the timing of tre

Published
2021

23. Reply by Authors

Author

Meijer, Dennie, primary, Luiting, Henk B., additional, van Leeuwen, Pim J., additional, Remmers, Sebastiaan, additional, Jansen, Bernard H. E., additional, Bodar, Yves J. L., additional, Witteveen, Thelma, additional, Schaake, Eva E., additional, van der Poel, Henk G., additional, Wondergem, Maurits, additional, Busstra, Martijn B., additional, Nieuwenhuijzen, Jakko A., additional, Meijnen, Philip, additional, Brabander, Tessa, additional, van Moorselaar, R. Jeroen A., additional, Hendrikse, N. Harry, additional, Oprea-Lager, Daniela E., additional, Roobol, Monique J., additional, and Vis, André N., additional

Published
2021
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24. Prostate Specific Membrane Antigen Positron Emission Tomography/Computerized Tomography in the Evaluation of Initial Response in Candidates Who Underwent Salvage Radiation Therapy after Radical Prostatectomy for Prostate Cancer

Author

Meijer, Dennie, primary, Luiting, Henk B., additional, van Leeuwen, Pim J., additional, Remmers, Sebastiaan, additional, Jansen, Bernard H. E., additional, Bodar, Yves J. L., additional, Witteveen, Thelma, additional, Schaake, Eva E., additional, van der Poel, Henk G., additional, Wondergem, Maurits, additional, Busstra, Martijn B., additional, Nieuwenhuijzen, Jakko A., additional, Meijnen, Philip, additional, Brabander, Tessa, additional, van Moorselaar, R. Jeroen A., additional, Hendrikse, N. Harry, additional, Oprea-Lager, Daniela E., additional, Roobol, Monique J., additional, and Vis, André N., additional

Published
2021
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25. Use of gallium-68 prostate-specific membrane antigen positron-emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

Author

Luiting, Henk, Leeuwen, PJ, Busstra, M.B., Brabander, Tessa, van der Poel, HG, Donswijk, ML, Vis, AN, Emmett, L, Stricker, PD, Roobol - Bouts, Monique, Luiting, Henk, Leeuwen, PJ, Busstra, M.B., Brabander, Tessa, van der Poel, HG, Donswijk, ML, Vis, AN, Emmett, L, Stricker, PD, and Roobol - Bouts, Monique

Published
2020

26. Distribution of prostate cancer recurrences on gallium-68 prostate-specific membrane antigen (Ga-68-PSMA) positron-emission/computed tomography after radical prostatectomy with pathological node-positive extended lymph node dissection

Author

Huits, TH, Luiting, Henk, van der Poel, HG, Nandurkar, R, Donswijk, M, Schaake, E, Vogel, W, Roobol - Bouts, Monique, Wit, E, Stricker, P, Emmett, L, van Leeuwen, P, Huits, TH, Luiting, Henk, van der Poel, HG, Nandurkar, R, Donswijk, M, Schaake, E, Vogel, W, Roobol - Bouts, Monique, Wit, E, Stricker, P, Emmett, L, and van Leeuwen, P

Published
2020

28. Optimal Timing of Prostate Specific Membrane Antigen Positron Emission Tomography/Computerized Tomography for Biochemical Recurrence after Radical Prostatectomy

Author

Luiting, Henk B., primary, van Leeuwen, Pim J., additional, Remmers, Sebastiaan, additional, Donswijk, Maarten, additional, Busstra, Martijn B., additional, Bakker, Ingrid L., additional, Brabander, T., additional, Stokkel, Marcel, additional, van der Poel, Henk G., additional, and Roobol, Monique J., additional

Published
2020
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29. Reply by Authors

Author

Luiting, Henk B., primary, van Leeuwen, Pim J., additional, Remmers, Sebastiaan, additional, Donswijk, Maarten, additional, Busstra, Martijn B., additional, Bakker, Ingrid L., additional, Brabander, T., additional, Stokkel, Marcel, additional, van der Poel, Henk G., additional, and Roobol, Monique J., additional

Published
2020
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30. Distribution of prostate cancer recurrences on gallium‐68 prostate‐specific membrane antigen (68Ga‐PSMA) positron‐emission/computed tomography after radical prostatectomy with pathological node‐positive extended lymph node dissection

Author

Huits, Thijs H., primary, Luiting, Henk B., additional, van der Poel, Henk G., additional, Nandurkar, Rohan, additional, Donswijk, Maarten, additional, Schaake, Eva, additional, Vogel, Wouter, additional, Roobol, Monique J., additional, Wit, Esther, additional, Stricker, Phillip, additional, Emmett, Louise, additional, and van Leeuwen, Pim J., additional

Published
2020
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31. Prostate cancer upgrading with serial prostate magnetic resonance imaging and repeat biopsy in men on active surveillance: are confirmatory biopsies still necessary?

Author

Osses, Daniël F., primary, Drost, Frank‐Jan H., additional, Verbeek, Jan F.M., additional, Luiting, Henk B., additional, van Leenders, Geert J.L.H., additional, Bangma, Chris H., additional, Krestin, Gabriel P., additional, Roobol, Monique J., additional, and Schoots, Ivo G., additional

Published
2020
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33. MP53-14 PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY AND A LOCAL RECURRENCE OR NEGATIVE PSMA PET/CT ARE EXCELLENT CANDIDATES FOR SALVAGE RADIOTHERAPY TO THE PROSTATIC FOSSA

Author

Meijer*, Dennie, primary, Luiting, Henk, additional, van Leeuwen, Pim, additional, Jansen, Bernard, additional, Bodar, Yves, additional, Remmers, Sebastiaan, additional, Witteveen, Thelma, additional, van der Poel, Henk, additional, Oprea-Lager, Daniela, additional, Roobol, Monique, additional, and Vis, André, additional

Published
2020
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35. Use of gallium‐68 prostate‐specific membrane antigen positron‐emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

Author

Luiting, Henk B., primary, van Leeuwen, Pim J., additional, Busstra, Martijn B., additional, Brabander, Tessa, additional, van der Poel, Henk G., additional, Donswijk, Maarten L., additional, Vis, André N., additional, Emmett, Louise, additional, Stricker, Phillip D., additional, and Roobol, Monique J., additional

Published
2019
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38. Distribution of prostate cancer recurrences on gallium‐68 prostate‐specific membrane antigen (68Ga‐PSMA) positron‐emission/computed tomography after radical prostatectomy with pathological node‐positive extended lymph node dissection

Author

Huits, Thijs H., Luiting, Henk B., Poel, Henk G., Nandurkar, Rohan, Donswijk, Maarten, Schaake, Eva, Vogel, Wouter, Roobol, Monique J., Wit, Esther, Stricker, Phillip, Emmett, Louise, and Leeuwen, Pim J.

Subjects
*LYMPHADENECTOMY, *PROSTATE-specific antigen, *CANCER relapse, *PROSTATE cancer, *PROSTATECTOMY, *TOMOGRAPHY, *GLEASON grading system, *VULVAR cancer, *LYMPHATIC metastasis
Abstract

Objectives: To examine the anatomical distribution of prostate cancer (PCa) recurrence on gallium‐68 prostate‐specific membrane antigen (68Ga‐PSMA) positron‐emission tomography (PET)/computed tomography (CT) in patients with biochemical recurrence (BCR) after undergoing radical prostatectomy (RP) with pathological lymph node metastasis (pN1) in their extended pelvic lymph node dissection (ePLND), and to compare the location of PCa recurrence with the location of the initial lymph node metastasis at ePLND. Materials and Methods: We retrospectively reviewed 100 patients with BCR (PSA 0.05–5.00 ng/mL) after RP with pN1 ePLND who underwent 68Ga‐PSMA PET/CT to guide salvage therapy. Clinical and pathological features and anatomical locations of PCa recurrence on 68Ga‐PSMA PET/CT were obtained, and management impact was recorded. Results: In all, 68 patients (68%) had a positive and 32 patients (32%) had a negative 68Ga‐PSMA PET/CT result. Of the 68 patients with a positive 68Ga‐PSMA PET/CT, 44 (65%) showed abnormal uptake only in the pelvic area, seven (10%) only outside the pelvic area, and 17 (25%) both within and outside the pelvic area. 68Ga‐PSMA PET/CT‐positive pelvic lymph nodes were often (84%) detected on the same side as the lymph node metastasis diagnosed at ePLND. Based on the outcomes of the 68Ga‐PSMA PET/CT, change of management was noted in 68% of the patients. Conclusion: Recurrence of PCa on 68Ga‐PSMA PET/CT was limited to the pelvis in the majority of patients with BCR after RP with pN1 ePLND. Moreover, recurrence was often detected on the same side as the lymph node metastasis at ePLND. The results confirm the diagnostic value of 68Ga‐PSMA PET/CT in patients with BCR after RP with pN1 ePLND. Prospective studies are needed to support the long‐term benefit of 68Ga‐PSMA PET/CT‐dictated management changes. [ABSTRACT FROM AUTHOR]

Published
2020
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39. Use of gallium‐68 prostate‐specific membrane antigen positron‐emission tomography for detecting lymph node metastases in primary and recurrent prostate cancer and location of recurrence after radical prostatectomy: an overview of the current literature

Author

Luiting, Henk B., Leeuwen, Pim J., Busstra, Martijn B., Brabander, Tessa, Poel, Henk G., Donswijk, Maarten L., Vis, André N., Emmett, Louise, Stricker, Phillip D., and Roobol, Monique J.

Subjects
*PROSTATE-specific antigen, *LYMPH nodes, *CANCER relapse, *LYMPHADENECTOMY, *PROSTATE cancer
Abstract

Objectives: To review the literature to determine the sensitivity and specificity of gallium‐68 prostate‐specific membrane antigen (68Ga‐PSMA) positron‐emission tomography (PET) for detecting pelvic lymph node metastases in patients with primary prostate cancer (PCa), and the positive predictive value in patients with biochemical recurrence (BCR) after initial curative treatment, and, in addition, to determine the detection rate and management impact of 68Ga‐PSMA PET in patients with BCR after radical prostatectomy (RP). Materials and Methods: We performed a comprehensive literature search. Search terms used in MEDLINE, EMBASE and Science Direct were '(PSMA, 68Ga‐PSMA, 68Gallium‐PSMA, Ga‐68‐PSMA or prostate‐specific membrane antigen)' and '(histology, lymph node, staging, sensitivity, specificity, positive predictive value, recurrence, recurrent or detection)'. Relevant abstracts were reviewed and full‐text articles obtained where possible. References to and from obtained articles were searched to identify further relevant articles. Results: Nine retrospective and two prospective studies described the sensitivity and specificity of 68Ga‐PSMA PET for detecting pelvic lymph node metastases before initial treatment, which ranged from 33.3% to 100% and 80% to 100%, respectively. In eight retrospective studies, the positive predictive value of 68Ga‐PSMA PET in patients with BCR before salvage lymph node dissection ranged from 70% to 100%. The detection rate of 68Ga‐PSMA PET in patients with BCR after RP in the PSA subgroups <0.2 ng/mL, 0.2–0.49 ng/mL and 0.5 to <1.0 ng/mL ranged from 11.3% to 50.0%, 20.0% to 72.7% and 25.0% to 87.5%, respectively. Conclusion: The review results showed that 68Ga‐PSMA PET had a high specificity for the detection of pelvic lymph node metastases in primary PCa. Furthermore, 68Ga‐PSMA PET had a very high positive predictive value in detecting lymph node metastases in patients with BCR. By contrast, sensitivity was only moderate; therefore, based on the currently available literature, 68Ga‐PSMA PET cannot yet replace pelvic lymph node dissection to exclude lymph node metastases. In the salvage phase, 68Ga‐PSMA PET had both a high detection rate and impact on radiotherapy planning in early BCR after RP. [ABSTRACT FROM AUTHOR]

Published
2020
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41. Distribution of prostate cancer recurrences on gallium-68 prostate-specific membrane antigen ( 68 Ga-PSMA) positron-emission/computed tomography after radical prostatectomy with pathological node-positive extended lymph node dissection.

Author

Huits TH, Luiting HB, van der Poel HG, Nandurkar R, Donswijk M, Schaake E, Vogel W, Roobol MJ, Wit E, Stricker P, Emmett L, and van Leeuwen PJ

Subjects
Aged, Gallium Isotopes, Gallium Radioisotopes, Humans, Lymph Node Excision, Male, Membrane Glycoproteins therapeutic use, Middle Aged, Neoplasm Recurrence, Local, Organometallic Compounds therapeutic use, Prostate diagnostic imaging, Prostate pathology, Prostatectomy, Radiopharmaceuticals therapeutic use, Retrospective Studies, Lymphatic Metastasis diagnostic imaging, Lymphatic Metastasis pathology, Positron Emission Tomography Computed Tomography methods, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms epidemiology, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery
Abstract

Objectives: To examine the anatomical distribution of prostate cancer (PCa) recurrence on gallium-68 prostate-specific membrane antigen ( 68 Ga-PSMA) positron-emission tomography (PET)/computed tomography (CT) in patients with biochemical recurrence (BCR) after undergoing radical prostatectomy (RP) with pathological lymph node metastasis (pN1) in their extended pelvic lymph node dissection (ePLND), and to compare the location of PCa recurrence with the location of the initial lymph node metastasis at ePLND., Materials and Methods: We retrospectively reviewed 100 patients with BCR (PSA 0.05-5.00 ng/mL) after RP with pN1 ePLND who underwent 68 Ga-PSMA PET/CT to guide salvage therapy. Clinical and pathological features and anatomical locations of PCa recurrence on 68 Ga-PSMA PET/CT were obtained, and management impact was recorded., Results: In all, 68 patients (68%) had a positive and 32 patients (32%) had a negative 68 Ga-PSMA PET/CT result. Of the 68 patients with a positive 68 Ga-PSMA PET/CT, 44 (65%) showed abnormal uptake only in the pelvic area, seven (10%) only outside the pelvic area, and 17 (25%) both within and outside the pelvic area. 68 Ga-PSMA PET/CT-positive pelvic lymph nodes were often (84%) detected on the same side as the lymph node metastasis diagnosed at ePLND. Based on the outcomes of the 68 Ga-PSMA PET/CT, change of management was noted in 68% of the patients., Conclusion: Recurrence of PCa on 68 Ga-PSMA PET/CT was limited to the pelvis in the majority of patients with BCR after RP with pN1 ePLND. Moreover, recurrence was often detected on the same side as the lymph node metastasis at ePLND. The results confirm the diagnostic value of 68 Ga-PSMA PET/CT in patients with BCR after RP with pN1 ePLND. Prospective studies are needed to support the long-term benefit of 68 Ga-PSMA PET/CT-dictated management changes., (© 2020 The Authors BJU International Published by John Wiley & Sons Ltd on behalf of BJU International.)

Published
2020
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