Management impact of 18F-DCFPyL PET/CT in hormone-sensitive prostate cancer patients with biochemical recurrence after definitive treatment: a multicenter retrospective study

Dennie Meijer, Pim J van Leeuwen, Pepijn M J Oosterholt, Yves J L Bodar, Henk G van der Poel, N Harry Hendrikse, Maarten L Donswijk, Maurits Wondergem, Annelies E Vellekoop, R Jeroen A van Moorselaar, Jakko A Nieuwenhuijzen, Daniela E Oprea-Lager, André N Vis

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: The aim of this study was to investigate whether an early, accurate identification of disease using 18F-DCFPyL PET/CT imaging resulted in a change of decision on treatment management, for individual patients with biochemically recurrent (BCR), hormone-sensitive prostate cancer. Methods: In this retrospective study, a total of 253 patients with BCR who underwent restaging 18F-DCFPyL PET/CT were assessed. Two urologists specialized in uro-oncology were asked to formulate a preferred treatment for each patient before and after knowing the results of the 18F-DCFPyL PET/CT. Results: Out of 253 patients, 191 (75%) underwent robot-assisted radical prostatectomy (RARP) as primary therapy, and 62 (25%) external beam radiation therapy (EBRT). In 103/253 cases (40.7%), a preferred treatment change based on the 18F-DCFPyL PET/CT findings was reported. In patients post-RARP, a positive 18F-DCFPyL PET/CT (OR 6.21; 95%CI 2.78–13.8; p < 0.001) and positive pathological lymph node status (pN1) (OR 2.96; 95%CI 1.15–7.60; p = 0.024) were significant predictors for an intended change of management, whereas a positive surgical margin (OR 0.42; 95%CI 0.20–0.88; p = 0.022) was inversely associated with an intended change of management. Conclusion: In this study, we found a significant impact of 18F-DCFPyL PET/CT on the intended management of patients with biochemically recurrent hormone-sensitive prostate cancer. A positive 18F-DCFPyL PET/CT scan, positive pathological lymph node status, and a negative surgical margin status were significantly associated with increased odds of having a change of management based on 18F-DCFPyL PET/CT findings.

Original languageEnglish
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Early online date5 Feb 2021
DOIs
Publication statusE-pub ahead of print - 5 Feb 2021

Cite this