TY  - JOUR
A1  - Knipper, Sophie
A1  - Lischewsk, Flemming
A1  - Koehler, Daniel
A1  - Eiber, Matthias
A1  - van Leeuwen, Fijs W. B.
A1  - de Barros, Hilda
A1  - Berrens, Anne-Claire
A1  - Zuur, Lotte
A1  - van Leeuwen, Pim J.
A1  - van der Poel, Henk
A1  - Ambrosini, Francesca
A1  - Falkenbach, Fabian
A1  - Budäus, Lars
A1  - Steuber, Thomas
A1  - Graefen, Markus
A1  - Tennstedt, Pierre
A1  - Gschwend, Jürgen E.
A1  - Horn, Thomas
A1  - Heck, Matthias M.
A1  - Maurer, Tobias
T1  - Biochemical response of <0.1 ng/ml predicts therapy-free survival of prostate cancer patients following prostate-specific membrane antigen–targeted salvage surgery
T2  - European Urology Oncology
N2  - 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.
Y1  - 2025
UR  - https://opus.bibliothek.uni-augsburg.de/opus4/frontdoor/index/index/docId/124380
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:384-opus4-1243802
SN  - 2588-9311
VL  - 8
IS  - 2
SP  - 270
EP  - 277
PB  - Elsevier BV
CY  - Amsterdam
ER  -