Study on the diagnostic and prognostic predictive value of PSMA-PET/CT for oligometastatic prostate cancer
Objective To evaluate the diagnostic and prognostic efficacy of PSMA-PET/CT in patients with oligometastatic prostate cancer receiving neoadjuvant therapy.Methods A total of 50 men with de novo oligometastatic prostate cancer were retrospectively enrolled.All patients underwent PSMA-PET/CT and other assessments at baseline and received 4-6 cycles of neoadjuvant androgen deprivation combined with chemotherapy,followed by robotic-assisted radical prostatectomy with pelvic lymph node dissection under general anesthesia,after which patients continued to receive androgen deprivation therapy.The relationship between PSMA-PET/CT imaging and other clinical factors was compared,and the influence of each clinical factor on prognosis was analyzed using Logistic regression.Results There was no significant difference in SUVmax level between the PSA level groups and the ISUP score groups.There was a significant difference in SUVmax level between the pelvic confined group and extrapelvic group(21.01 vs.47.06,P=0.005 9).Univariate Logistic regression showed that SUVmax(OR=1.032,95％CI=1.002-1.063,P=0.040)and whether pelvic confined or not(based on PSMA-PET/CT)(OR=5.630,95％CI=1.648-19.232,P=0.006)were significantly associated with prognosis.Multivariate Logistic regression revealed that whether pelvic confined or not(based on PSMA-PET/CT)was an independent predicting factor of prognosis(OR=3.879,95％CI=1.066-14.121,P=0.040).Conclusion The PSMA-PET/CT can more accurately estimate the site of metastasis,and also predict the short-and medium-term post-operation prognosis outcomes to a certain extent,which provides a reference for the development of individualized treatment regime.
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