Affordable Access

deepdyve-link
Publisher Website

Identification of Recurrence Sites Following Post-Prostatectomy Treatment for Prostate Cancer Using 11C-Choline Positron Emission Tomography and Multiparametric Pelvic Magnetic Resonance Imaging.

Authors
  • Nehra, Avinash1
  • Parker, William P1
  • Haloi, Rimki1
  • Park, Sean S2
  • Mynderse, Lance A1
  • Lowe, Val J3
  • Davis, Brian J2
  • Quevedo, J Fernando4
  • Johnson, Geoffrey B3
  • Kwon, Eugene D1
  • Karnes, R Jeffrey5
  • 1 Department of Urology, Mayo Clinic, Rochester, Minnesota.
  • 2 Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
  • 3 Department of Radiology, Mayo Clinic, Rochester, Minnesota.
  • 4 Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota.
  • 5 Department of Urology, Mayo Clinic, Rochester, Minnesota. Electronic address: [email protected]
Type
Published Article
Journal
The Journal of urology
Publication Date
Mar 01, 2018
Volume
199
Issue
3
Pages
726–733
Identifiers
DOI: 10.1016/j.juro.2017.09.033
PMID: 28916273
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We describe anatomical sites of recurrence in patients with prostate cancer who had biochemical recurrence following radical prostatectomy and who received radiotherapy and/or androgen deprivation therapy postoperatively. We performed 11C-choline positron emission tomography/computerized tomography and multiparametric magnetic resonance imaging. After radiotherapy and/or androgen deprivation therapy patients who underwent radical prostatectomy were evaluated by 11C-choline positron emission tomography/computerized tomography and multiparametric magnetic resonance imaging to determine recurrence patterns and clinicopathological features. Recurrent sites were described as local only (seminal vesicle bed/prostate fossa, vesicourethral anastomosis and bladder neck) or distant metastatic disease. Features associated with the identification of any distant metastatic disease were evaluated by multivariable logistic regression. A total of 550 patients were identified. Treatment included androgen deprivation therapy in 108, radiotherapy in 201, and androgen deprivation therapy and radiotherapy in 241. Median prostate specific antigen at evaluation was 3.9, 3.6 and 2.8 ng/ml in patients treated with androgen deprivation therapy, radiotherapy and a combination, respectively. Recurrence developed locally in 77 patients (14%), as distant metastasis only in 411 (75%), and as local and distant metastatic disease in 62 (11%). On multivariable analysis treatment with radiotherapy (OR 7.18, 95% CI 2.92-17.65), and radiotherapy and hormonal therapy (OR 9.23, 95% CI 3.90-21.87, all p <0.01) was associated with increased odds of distant failure at evaluation. The combination of 11C-choline positron emission tomography/computerized tomography and multiparametric magnetic resonance imaging successfully identified patterns of recurrence after postoperative radiotherapy and/or androgen deprivation therapy at a median prostate specific antigen of less than 4 ng/ml. Half of this cohort had local only recurrence and/or a low disease burden limited to pelvic lymph nodes. These patients may benefit from additional local therapy. These data and this analysis may facilitate the evaluation of such patients with biochemically recurrent prostate cancer. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Report this publication

Statistics

Seen <100 times