The PRIMARY score was implemented in Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) version 2 to improve accuracy for the diagnosis of clinically significant prostate cancer using prostate-specific membrane antigen (PSMA) positron emission tomography (PET).
We reviewed overall survival (OS) for patients who underwent PSMA PET for initial staging to evaluate the prognostic value of PRIMARY in a large, international, multicenter cohort. The cohort comprised 1889 patients who underwent PSMA PET for initial staging of prostate cancer at investigator sites across Europe and Australia between 2012 and 2021. Hazard ratios (HRs) with 95% confidence interval (CI) were calculated for PRIMARY scores to identify predictors of OS. Complete-case head-to-head comparisons were conducted for Prostate Imaging-Reporting and Data System (PI-RADS) versus PRIMARY scores, and cT stage versus PRIMARY scores. We present preliminary findings up to January 31, 2025, when 231 deaths had occurred. PRIMARY score 5 (HR 1.5, 95% CI 1.0-2.3; p = 0.045) was associated with shorter OS. Improvements in C index values confirmed the added prognostic value of the PRIMARY score when combined with PI-RADS or cT stage. PRIMARY score 5 on initial PSMA PET is prognostic for shorter OS. There is ongoing long-term follow-up in the PROMISE registry (NCT06320223, promise-pet.org).
European urology. 2025 Oct 29 [Epub ahead of print]
Madeleine J Karpinski, Sebastian Hoberück, Wolfgang P Fendler, Caner Civan, Ralph A Bundschuh, Christian Thomas, Anders Bjartell, Elin Trägårdh, Timo F W Soeterik, Laura Evangelista, Andrej Vondrak, Sazan Rasul, Laura Forner, Andrea Di Giorgio, Helen Scholtissek, Jonathan Miksch, Adrien Holzgreve, Francesco Lanfranchi, Kambiz Rahbar, Michael S Hofman, Isabel Rauscher, Osman Güven, Matthias Eiber, Narjess Ayati, Lale Umutlu, Ken Herrmann, Boris Hadaschik, Louise Emmett
Department of Nuclear Medicine, DKTK and NCT University Hospital Essen, Essen, Germany; Department of Nuclear Medicine, University Hospital Münster, Münster, Germany. Electronic address: ., Department of Nuclear Medicine, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany., Department of Nuclear Medicine, DKTK and NCT University Hospital Essen, Essen, Germany., Department of Urology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany., Department of Urology, Skåne University Hospital, Malmö, Sweden; Department of Translational Medicine, Lund University, Malmö, Sweden., Department of Translational Medicine, Lund University, Malmö, Sweden; Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, Sweden; Wallenberg Centre of Molecular Medicine, Lund University, Lund, Sweden., Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Urology, St. Antonius Hospital, Nieuwegein/Utrecht, The Netherlands., Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy., Nuclear Medicine Department, IZOTOPCENTRUM s.r.o, Nitra, Slovakia., Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria., Department of Nuclear Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy., Department of Nuclear Medicine, University of Augsburg, Augsburg, Germany., Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Radiology, Ulm University Hospital, Ulm, Germany., Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany; Ahmanson Translational Theranostics Division, UCLA David Geffen School of Medicine, Los Angeles, CA, USA., Department of Experimental Medicine, University of Genoa, Genoa, Italy., Department of Nuclear Medicine, University Hospital Münster, Münster, Germany., Prostate Cancer Theranostics and Imaging Centre of Excellence, Peter MacCallum Centre Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia., Department of Nuclear Medicine, School of Medicine and Health, TUM University Hospital, Munich, Germany., Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, Australia., Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany., Department of Urology, DKTK and NCT University Hospital Essen, Essen, Germany.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/41168067