We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The role of PSMA PET/CT in predicting downgrading in patients with Gleason score 4+4 prostate cancer in prostate biopsy.
- Authors
Aykanat, Ibrahim Can; Kordan, Yakup; Seymen, Hulya; Koseoglu, Ersin; Ozkan, Arif; Esen, Baris; Tarim, Kayhan; Kulac, Ibrahim; Falay, Okan; Gurses, Bengi; Baydar, Dilek Ertoy; Canda, Abdullah Erdem; Balbay, Mevlana Derya; Demirkol, Mehmet Onur; Esen, Tarik
- Abstract
Background: To investigate the predictable parameters associated with downgrading in patients with a Gleason score (GS) 8 (4+4) in prostate biopsy after radical prostatectomy. Methods: We retrospectively analyzed 62 patients with a GS of 4+4 on prostate biopsy who underwent robotic radical prostatectomy between 2017 and 2022. Results: 38 of 62 (61.2%) were downgraded. In multivariable logistic regression model, Ga-68 prostate-specific membrane antigen (PSMA) positron-emission tomography (PET)/computed tomography (CT) SUV max was independent predictor of downgrading (OR 0.904; p = 0.011) and a Logistic Regression model was constructed using the following formula: Y = 1.465–0.95 (PSMA PET/CT SUV max). The model using this variable correctly predicted the downgrading in 72.6% of patients. The AUC for PSMA PET/CT SUV max was 0.709 the cut off being 8.8. A subgroup analysis was performed in 37 patients who had no other European Association of Urology (EAU) high risk features. 25 out of 37 (67.5%) were downgraded, and 21 of these 25 had organ confined disease. Low PSMA SUV max (<8.1) and percentage of GS 4+4 biopsy cores to cancer bearing cores (45.0%) were independently associated with downgrading to GS 7. Conclusion: PSMA PET/CT can be used to predict downgrading in patients with GS 4+4 PCa. Patients with GS 4+4 disease, but no other EAU high risk features, low percentage of GS 4+4 biopsy cores to cancer bearing cores, and a low PSMA PET/CT SUV max are associated with a high likelihood of the cancer reclassification to intermediate risk group.
- Subjects
UGANDA; PROSTATE cancer; PROSTATE biopsy; PROSTATE-specific membrane antigen; GLEASON grading system; RADICAL prostatectomy; LOGISTIC regression analysis
- Publication
World Journal of Urology, 2024, Vol 42, Issue 1, p1
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-024-05012-2