Biochemical Response of <0.1 ng/ml Predicts Therapy-free Survival of Prostate Cancer Patients following Prostate-specific Membrane Antigen-targeted Salvage Surgery.

Knipper, Sophie; Lischewski, Flemming; Koehler, Daniel; Eiber, Matthias; van Leeuwen, Fijs W B; de Barros, Hilda; Berrens, Anne-Claire; Zuur, Lotte; van Leeuwen, Pim J; van der Poel, Henk; Ambrosini, Francesca; Falkenbach, Fabian; Budäus, Lars; Steuber, Thomas; Graefen, Markus; Tennstedt, Pierre; Gschwend, Jürgen E; Horn, Thomas; Heck, Matthias M; Maurer, Tobias

doi:10.1016/j.euo.2024.04.019

journal article

Titel:: Biochemical Response of <0.1 ng/ml Predicts Therapy-free Survival of Prostate Cancer Patients following Prostate-specific Membrane Antigen-targeted Salvage Surgery.
Dokumenttyp:: Journal Article
Autor(en):: Knipper, Sophie; Lischewski, Flemming; Koehler, Daniel; Eiber, Matthias; van Leeuwen, Fijs W B; de Barros, Hilda; Berrens, Anne-Claire; Zuur, Lotte; van Leeuwen, Pim J; van der Poel, Henk; Ambrosini, Francesca; Falkenbach, Fabian; Budäus, Lars; Steuber, Thomas; Graefen, Markus; Tennstedt, Pierre; Gschwend, Jürgen E; Horn, Thomas; Heck, Matthias M; Maurer, Tobias
Abstract:: BACKGROUND: In a subset of patients with oligorecurrent prostate cancer (PCa), salvage surgery with prostate-specific membrane antigen (PSMA) radioguided surgery (PSMA-RGS) seems to be of value. OBJECTIVE: To evaluate whether a lower level of postoperative prostate-specific antigen (PSA; <0.1 ng/ml) is predictive of therapy-free survival (TFS) following salvage PSMA-RGS. DESIGN, SETTING, AND PARTICIPANTS: This cohort study evaluated patients with biochemical recurrence after radical prostatectomy and oligorecurrent PCa on PSMA positron emission tomography treated with PSMA-RGS in three tertiary care centers (2014-2022). INTERVENTION: PSMA-RGS. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Postsalvage surgery PSA response was categorized as <0.1, 0.1-<0.2, or >0.2 ng/ml. Kaplan-Meier and multivariable Cox regression models evaluated TFS according to PSA response. RESULTS AND LIMITATIONS: Among 553 patients assessed, 522 (94%) had metastatic soft tissue lesions removed during PSMA-RGS. At 2-16 wk after PSMA-RGS, 192, 62, and 190 patients achieved PSA levels of <0.1, 0.1-<0.2, and >0.2 ng/ml, respectively. At 2 yr of follow-up, TFS rate was 81.1% versus 56.1% versus 43.1% (p < 0.001) for patients with PSA <0.1 versus 0.1-<0.2 versus >0.2 ng/ml. In multivariable analyses, PSA levels of 0.1-0.2 ng/ml (hazard ratio [HR]: 1.9, confidence interval [CI]: 1.1-3.1) and ≥0.2 ng/ml (HR: 3.2, CI: 2.2-4.6, p < 0.001) independently predicted the need for additional therapy after PSMA-RGS. The main limitation is the lack of a control group. CONCLUSIONS: For patients after salvage PSMA-RGS, a lower biochemical response (PSA <0.1 ng/ml) seems to predict longer TFS. This insight may help in counseling patients postoperatively as well as guiding the timely selection of additional therapy. PATIENT SUMMARY: We studied what happened to prostate cancer patients in three European centers who had salvage surgery using a special method called prostate-specific membrane antigen-targeted radioguidance. We found that patients who had low prostate-specific antigen levels soon after surgery were less likely to need further treatment for a longer time.
Zeitschriftentitel:: Eur Urol Oncol
Jahr:: 2025
Band / Volume:: 8
Heft / Issue:: 2
Seitenangaben Beitrag:: 270-277
Volltext / DOI:: doi:10.1016/j.euo.2024.04.019
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/38729805
Print-ISSN:: 2588-9311
TUM Einrichtung:: Klinik und Poliklinik für Nuklearmedizin (Prof. Weber); Klinik und Poliklinik für Urologie (Prof. Gschwend)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Urologie (Prof. Gschwend)2025

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Nuklearmedizin (Prof. Weber)2025