In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 6_suppl ( 2018-02-20), p. 270-270
Abstract:
270 Background: Positron-emission tomography (PET) directed against PSMA allows detection of even small metastatic prostate cancer (PC) lesions at low PSA values. In a subset of patients (pts) with recurrent PC salvage surgery might be beneficial. To facilitate removal during salvage surgery, we recently introduced PSMA-targeted radioguided surgery (PSMA-RGS). Methods: 121 consecutive patients with recurrent PC (PSA median: 1.13 ng/ml, range: 0.00 – 13.90 ng/ml; 9 pts under androgen-deprivation therapy) and soft-tissue lesions on 68 Ga-PSMA PET after radical prostatectomy underwent 111 In- or 99m Tc-based PSMA-RGS between April 2014 and May 2017. The rate of complete biochemical response (cBR; PSA 〈 0.2ng/ml) was determined 6-16 weeks following PSMA-RGS. Biochemical recurrence-free survival (bRFS), PC-specific treatment-free survival and postoperative complications were evaluated. Results: Metastatic soft-tissue lesions from PC metastases could be removed in 120/121 pts (99.2%). One patient died six days postoperatively from a pulmonary embolism, five patients were lost to follow-up. Eleven pts suffered from Clavien grade III complications within 90d from surgery. In 75 out of 115 (65.2%) pts cBR was achieved. cBR was more likely in patients with a preoperative PSA level 〈 1.13 (76.3% vs. 52.7%) or a single anatomical location of recurrence (71.9% vs. 58.8%). Median bRFS was 5.1 months. At the time of analysis, 15 pts exhibited an ongoing cBR for at least 12 months (range: 12-32 months). A significantly longer bRFS was achieved in pts with a preoperative PSA 〈 1.13 ng/ml (median 14.9 vs 3.2 months, p = 0.02). In pts with a single compared to multiple location of recurrence we observed a trend towards a longer median bRFS (8.2 months vs. 3.5 months, p = 0.08). After one year of follow-up, 61.6 % of pts did not receive any further PC-directed treatment. Conclusions: PSMA-RGS is a promising tool to enhance intraoperative detection of metastatic lesions in PC with an acceptable complication rate. It leads to a high number of biochemical response with substantial duration in a subset of pts. Our data showed that bRFS was highest in patients with a low preoperative PSA and a single anatomical site of recurrence.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2018.36.6_suppl.270
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2018
detail.hit.zdb_id:
2005181-5
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