The aim of this study was to investigate whether an early, accurate identification of disease using 18F-DCFPyL PET/CT imaging resulted in a change of decision on treatment management, for individual patients with biochemically recurrent (BCR), hormone-sensitive prostate cancer.
In this retrospective study, a total of 253 patients with BCR who underwent restaging 18F-DCFPyL PET/CT were assessed. Two urologists specialized in uro-oncology were asked to formulate a preferred treatment for each patient before and after knowing the results of the 18F-DCFPyL PET/CT.
Out of 253 patients, 191 (75%) underwent robot-assisted radical prostatectomy (RARP) as primary therapy, and 62 (25%) external beam radiation therapy (EBRT). In 103/253 cases (40.7%), a preferred treatment change based on the 18F-DCFPyL PET/CT findings was reported. In patients post-RARP, a positive 18F-DCFPyL PET/CT (OR 6.21; 95%CI 2.78-13.8; p < 0.001) and positive pathological lymph node status (pN1) (OR 2.96; 95%CI 1.15-7.60; p = 0.024) were significant predictors for an intended change of management, whereas a positive surgical margin (OR 0.42; 95%CI 0.20-0.88; p = 0.022) was inversely associated with an intended change of management.
In this study, we found a significant impact of 18F-DCFPyL PET/CT on the intended management of patients with biochemically recurrent hormone-sensitive prostate cancer. A positive 18F-DCFPyL PET/CT scan, positive pathological lymph node status, and a negative surgical margin status were significantly associated with increased odds of having a change of management based on 18F-DCFPyL PET/CT findings.
European journal of nuclear medicine and molecular imaging. 2021 Feb 05 [Epub ahead of print]
Dennie Meijer, Pim J van Leeuwen, Pepijn M J Oosterholt, Yves J L Bodar, Henk G van der Poel, N Harry Hendrikse, Maarten L Donswijk, Maurits Wondergem, Annelies E Vellekoop, R Jeroen A van Moorselaar, Jakko A Nieuwenhuijzen, Daniela E Oprea-Lager, André N Vis
Department of Urology, Prostate Cancer Network the Netherlands, Amsterdam University Medical Center, VU University, De Boelelaan 1117, 1081, Amsterdam, HV, The Netherlands. ., Department of Urology, Prostate Cancer Network the Netherlands, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Urology, Prostate Cancer Network the Netherlands, Amsterdam University Medical Center, VU University, De Boelelaan 1117, 1081, Amsterdam, HV, The Netherlands., Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands., Department of Nuclear Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands., Department of Urology, Amstelland Hospital, Amstelveen, The Netherlands.