TY - JOUR
T1 - Detection of Recurrent Prostate Cancer Using Prostate-specific Membrane Antigen Positron Emission Tomography in Patients not Meeting the Phoenix Criteria for Biochemical Recurrence After Curative Radiotherapy
AU - Jansen, Bernard H. E.
AU - van Leeuwen, Pim J.
AU - Wondergem, Maurits
AU - van der Sluis, Tim M.
AU - Nieuwenhuijzen, Jakko A.
AU - Knol, Remco J. J.
AU - van Moorselaar, Reindert J. A.
AU - van der Poel, Henk G.
AU - Oprea-Lager, Daniela E.
AU - Vis, André N.
N1 - Publisher Copyright: Copyright © 2020. Published by Elsevier B.V.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Biochemical recurrence of prostate cancer (PCa) after curative radiotherapy is defined as a prostate-specific antigen (PSA) rise of ≥2 ng/ml above the nadir ("Phoenix criteria", 2005). With the introduction of prostate-specific membrane antigen positron emission tomography (PSMA-PET), the ability to localise PCa recurrences has increased markedly. Here, we reviewed 315 patients scanned with PSMA-PET after curative radiotherapy in the Prostate Cancer Network Amsterdam (2015-2018). Sixty-three patients (20.3%) were scanned below the Phoenix threshold (PSA rise <2.0 ng/ml). In 53 of these patients (84.1%), PSMA-PET-avid lesions were detected nonetheless: 21 patients (33.3%) revealed a local recurrence as a single site of disease, 32 patients (50.8%) harboured metastatic PCa. Besides rising PSA, no predictors were identified that prompted early PSMA-PET imaging. In this communication, we report on the frequent detection of metastatic PCa with PSMA-PET in men below the Phoenix PSA threshold. These findings are a plea for re-evaluation of current diagnostic work-up for rising PSA values after radiotherapy, as early detection of recurrences might refine salvage and/or adjuvant therapies. PATIENT SUMMARY: This study reports on the unexpected detection of prostate cancer (PCa) recurrences with prostate-specific membrane antigen positron emission tomography in patients treated with radiotherapy. This calls for re-evaluation of the current criteria for recurrent PCa after radiotherapy.
AB - Biochemical recurrence of prostate cancer (PCa) after curative radiotherapy is defined as a prostate-specific antigen (PSA) rise of ≥2 ng/ml above the nadir ("Phoenix criteria", 2005). With the introduction of prostate-specific membrane antigen positron emission tomography (PSMA-PET), the ability to localise PCa recurrences has increased markedly. Here, we reviewed 315 patients scanned with PSMA-PET after curative radiotherapy in the Prostate Cancer Network Amsterdam (2015-2018). Sixty-three patients (20.3%) were scanned below the Phoenix threshold (PSA rise <2.0 ng/ml). In 53 of these patients (84.1%), PSMA-PET-avid lesions were detected nonetheless: 21 patients (33.3%) revealed a local recurrence as a single site of disease, 32 patients (50.8%) harboured metastatic PCa. Besides rising PSA, no predictors were identified that prompted early PSMA-PET imaging. In this communication, we report on the frequent detection of metastatic PCa with PSMA-PET in men below the Phoenix PSA threshold. These findings are a plea for re-evaluation of current diagnostic work-up for rising PSA values after radiotherapy, as early detection of recurrences might refine salvage and/or adjuvant therapies. PATIENT SUMMARY: This study reports on the unexpected detection of prostate cancer (PCa) recurrences with prostate-specific membrane antigen positron emission tomography in patients treated with radiotherapy. This calls for re-evaluation of the current criteria for recurrent PCa after radiotherapy.
KW - Biochemical recurrence
KW - Prostate cancer
KW - Prostate-specific membrane antigen positron emission tomography
KW - Radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85099267277&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.euo.2020.01.002
DO - https://doi.org/10.1016/j.euo.2020.01.002
M3 - Article
C2 - 32088155
SN - 2588-9311
VL - 4
SP - 821
EP - 825
JO - European Urology Oncology
JF - European Urology Oncology
IS - 5
ER -