Radical Prostatectomy Without Prior Biopsy in Selected Patients Evaluated by 18F-Labeled Prostate-Specific Membrane Antigen-Ligand Positron Emission Tomography/Computed Tomography and Multiparameter Magnetic Resonance Imaging: A Single-Center, Prospective, Single-Arm Trial.
J Urol
; 212(2): 280-289, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38885328
ABSTRACT
PURPOSE:
This study aimed to verify the feasibility and short-term prognosis of prostatectomy without biopsy. MATERIALS ANDMETHODS:
Patients with a rising PSA level ranging from 4 to 30 ng/mL were scheduled for multiparametric (mp) MRI and 18F-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET). Forty-seven patients (cT2N0M0) with Prostate Imaging Reporting and Data System ≥ 4 and molecular imaging PSMA score ≥ 2 were enrolled. All candidates underwent robot-assisted laparoscopic radical prostatectomy without biopsy. Prostate cancer detection rate, index tumors localization correspondence rate, positive surgical margin, complications, postoperative hospital stay, and PSA level in a 6-week postoperative follow-up visit were collected.RESULTS:
All the patients with positive mpMRI and PSMA PET were diagnosed with clinically significant prostate cancer. A total of 80 lesions were verified as cancer by pathology, of which 63 cancer lesions were clinically significant prostate cancer. Fifty-one lesions were simultaneously found by mpMRI and PSMA PET. A total of 23 lesions were invisible on either image, and all lesions were ≤ International Society of Urological Pathology 2 or ≤ 15 mm. Forty-five (95.7%) index tumors found by mpMRI combined with PSMA PET were consistent with pathology. Nine patients reported positive surgical margin.CONCLUSIONS:
Biopsy-free prostatectomy is safe and feasible for patients with evaluation strictly by mpMRI combined with 18F-PSMA PET/CT.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostatectomy
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Prostatic Neoplasms
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Positron Emission Tomography Computed Tomography
/
Multiparametric Magnetic Resonance Imaging
Limits:
Aged
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
J Urol
Year:
2024
Type:
Article
Affiliation country:
China