Distant Nodes Seen on PSMA PET-CT Staging Predicts Post-Treatment Progression in Men with Newly Diagnosed Prostate Cancer-A Prospective Cohort Study.

PSMA PET-CT scans are now recommended in international urological guidelines for primary staging and re-staging of prostate cancer. However, there is little published literature on the clinical outcomes for patients after treatment decisions made using PSMA PET-CT results. This is a multisite, prospective cohort study investigating the clinical outcomes of men who received treatment plans based on PSMA PET-CT results for primary staging. Men with biopsy proven prostate cancer received a PSMA PET-CT scan for primary staging. Treatment plans were recommended by multidisciplinary teams (MDT). After treatment, these men were followed with 6 monthly PSA tests and imaging or biopsies if recommended by MDT. The primary outcome was treatment progression defined as the addition or change of any treatment modalities such as androgen deprivation therapy, radiation therapy or chemotherapy. In total, 80% of men did not have any treatment progression after enactment of treatment based on PSMA PET-CT primary staging results at 29 months of follow up. Men who had distant nodes seen on PSMA PET-CT had a 5 times increased risk of treatment progression. Larger studies with longer follow up are needed to validate our results and optimise the way clinicians use PSMA PET-CT results to guide management.

Cancers. 2022 Dec 13*** epublish ***

Sean Ong, Claire Pascoe, Brian D Kelly, Zita Ballok, David Webb, Damien Bolton, Declan Murphy, Shomik Sengupta, Patrick Bowden, Nathan Lawrentschuk

EJ Whitten Foundation Prostate Cancer Research Centre, Epworth HealthCare, Richmond, VIC 3121, Australia., Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia., Department of Nuclear Medicine, Richmond Medical Imaging, Richmond, VIC 3121, Australia., Department of Urology, Eastern Health, Box Hill, VIC 3128, Australia.