Dados do Trabalho

Título

EVALUATION OF BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY IN PROSTATE CANCER WITH PET/CT PSMA-68Ga – EXPERIENCE OF A REFERENCE SERVICE IN PERNAMBUCO

Introdução

Prostate Cancer is the second most common neoplasm in the world. It is estimated that 12.1% of men will develop prostate cancer throughout their lifetime, with an incidence increasing with age. In Brazil, it is the most frequent neoplasm with 65,840 new cases in 2020, being the second leading cause of cancer death in men.

After radical prostatectomy (RP), around 20 to 40% of patients will relapse within 10 years4. Many of these will evolve with elevated serum prostate specific antigen (PSA) without clinically apparent disease, characterizing biochemical recurrence. And it is in this context that the performance of imaging tests to detect the presence of disease and the presence of anatomical substrate comes into play.

PET/CT (positron emission computed tomography) with PSMA-68Ga has been shown to be superior to traditional imaging tests, becoming an important tool in therapeutic decision-making.

Objetivo

The aim of this study is to evaluate the performance of PET/CT PSMA-68Ga in the assessment of biochemical recurrence in patients undergoing radical prostatectomy through measures of sensitivity and specificity, to correlate the test detection index with Gleason score and PSA level and compare the recurrence pattern with data already published.

Método

Retrospective analysis through electronic chart of 213 patients who underwent PSMA-68Ga PET/CT due to biochemical recurrence after RP in a single center of nuclear medicine, between 2016 and 2020.

Resultado

Median was 69 years (46 to 92). Median PSA level before PET was 0,55ng/ml. Overall positivity rate was 61% (130 patients). Prostate bed positivity was the most common finding (33%). A statistically significant evidence was found between the PSA value and the test positivity (p<0,001). In the analysis of the ROC curve, a PSA level ≥ 0,49ng/ml showed a sensitivity of 68% and a specificity of 71% (p<0,001).
In univariate analysis, there was no relationship between Gleason score and test positivity.
Regarding the number of lesions, 89.2% were considered to be oligometastatic (≤ 5 lesions).

Conclusão

PSMA-68Ga PET/CT detected tumor lesion in a high percentage of patients with biochemical recurrence, showing a clear relationship with PSA levels. It was not found significant association between Gleason score and test positivity.

Palavras-chave

prostate cancer / 68Ga-PSMA PET/CT / biochemical recurrence

Área

Oncologia - Tumores Urológicos - Próstata