Lymph Node Involvement in Treatment-Naive Prostate Cancer Patients: Correlation of PSMA PET/CT Imaging and Roach Formula in 280 Men in Radiotherapeutic Management
Lymph Node Involvement in Treatment-Naive Prostate Cancer Patients: Correlation of PSMA PET/CT Imaging and Roach Formula in 280 Men in Radiotherapeutic Management
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DOI：
10.2967/jnumed.119.227637
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发表时间：
2020-01-01
影响因子：
9.3
通讯作者：
Giesel, Frederik L.
中科院分区：
文献类型：
--
作者：
Koerber, Stefan A.;Stach, Gerald;Giesel, Frederik L.
前列腺特异性膜抗原（PSMA）PET/CT对初次治疗的前列腺癌患者的主要分期的重要性仍在争论中。因此，本研究旨在评价PSMA PET/CT在检测大型男性队列淋巴结转移中的作用，并根据Roach公式将成像结果与淋巴结受累风险进行比较。方法：共280例新诊断的前列腺癌患者纳入本研究。对于所有患者，进行PSMA PET/CT进行主要分期。中位年龄为67岁（范围，38-84岁），根据d 'Amico标准，所有患者中有84%被归类为高风险。使用Roach公式计算淋巴结受累的风险，并与PSMA PET/CT结果进行比较。结果：在280例男性中，90例（32.1%）检测到PSMA阳性淋巴结。虽然大多数淋巴结转移发生在盆腔内，但36.0%发生在盆腔外部位。在9例患者（3.2%）中，淋巴结转移发生在Virchow结。将PSMA数据与Roach公式的结果进行比较后，Roach预测的曲线下面积为0.781。结论：对于未经治疗的前列腺癌患者，PSMA PET/CT非常适合检测淋巴结转移。然而，最初的Roach公式仍然可以用于在日常临床常规中快速评估潜在的淋巴扩散。
The importance of prostate-specific membrane antigen (PSMA) PET/CT for primary staging of treatment-naive prostate cancer patients is still under debate. Therefore, the present study aimed to evaluate the role of PSMA PET/CT in detecting nodal metastases in a large cohort of men and compare imaging results with the risk of lymph node involvement based on the Roach formula. Methods: In total, 280 men with newly diagnosed prostate carcinoma were included in the present study. For all patients, PSMA PET/CT was performed for primary staging. Median age was 67 y (range, 38-84 y), and 84% of all patients were classified as high-risk according to the d'Amico criteria. The risk of lymph node involvement was calculated using the Roach formula and compared with the PSMA PET/CT results. Results: PSMA-positive nodes were detected in 90 of 280 men (32.1%). Although most nodal metastases occurred within the pelvis, 36.0% were in extrapelvic sites. In 9 patients (3.2%), nodal metastases occurred in the Virchow node. After comparison of PSMA data with the results of the Roach formula, an area under the curve of 0.781 was obtained for the Roach predictions. Conclusion: For treatment-naive prostate cancer patients, PSMA PET/CT is well suited for the detection of nodal metastases. However, the original Roach formula can still be used for a quick assessment of potential lymphatic spread in daily clinical routine.