Research Frontiers A new technology for the detection of lymph node metastases in patients with prostate cancer: prostate-specific membrane antigen radioguided surgery

The safety, feasibility and oncology results of prostate-specific membrane antigen (PSMA) radiation-guided surgery (PSMA-RGS) in patients with prostate cancer (PCa) have been reported, but the feasibility of robotic-assisted PSMA-RGS and the recognition of lymph node infiltration (LNI) effects are insufficient

Enlarged pelvic lymph node dissection (ePLND) is the gold standard

This phase II prospective study (NCT04832958) plans to include 100 patients with medium- to high-risk PCa who have no evidence of lymph nodes or distant metastases (cN0cM0) on routine imaging studies who plan to receive RARP+ePLND, and their LNI risk >5%.

Figure 1 Research process

Of the 12 patients, 4 (33%), 6 (50%), and 2 (17%) were intermediate, high-risk, and locally advanced PCa

Three patients (25%) had LNI

Table 1 Diagnostic accuracy of 96 lymph node region samples

Table 2 Diagnostic accuracy for patients

Robotic-assisted PSMA-RGS is a safe and feasible method for early identification and staging of LNI in PCa patients, with good specificity but poor sensitivity, and possible missed detection of micrometastatic lymph nodes
.

References:

Gandaglia G, Mazzone E, Stabile A, et al.
Prostate-specific membrane antigen Radioguided Surgery to Detect Nodal Metastases in Primary Prostate Cancer Patients Undergoing Robot-assisted Radical Prostatectomy and Extended Pelvic Lymph Node Dissection: Results of a Planned Interim Analysis of a Prospective Phase 2 Study.
Eur Urol.
2022 Oct; 82(4):411-418.

Editor: Wang Mumu

Reviewer: LR

Execution: Wang Mumu