PSMA-ligand uptake can serve as a novel biomarker in primary prostate cancer to predict outcome after radical prostatectomy

Abstract Background The prostate-specific membrane antigen (PSMA) is a relevant target in prostate cancer, and immunohistochemistry studies showed associations with outcome. PSMA-ligand positron emission tomography (PET) increasingly used for primary cancer staging, the molecular imaging TNM classification (miTNM) standardizes its reporting. We aimed to investigate potential of PET-imaging serve as noninvasive biomarker predict disease outcome after radical prostatectomy (RP). Methods In this retrospective analysis, 186 patients treated RP who had undergone 68 Ga-PSMA-11 PET up three months prior surgery were included. Maximum standardized uptake value (SUV max ), SUV mean , tumor volume (TV) total lesion (TL) collected from PET-imaging. Moreover, clinicopathological information, including age, serum (PSA) level, pathological characteristics, was assessed prediction. A stage group system findings based on miTNM framework developed. Results At median follow-up 38 (interquartile range (IQR) 22–53), biochemical recurrence (BCR) observed 58 during period. significant association between positive surgical margin miN status (miN1 vs. miN0, odds ratio (OR): 5.428, p = 0.004) detected. miT (miT ≥ 3a < 3, OR: 2.696, 0.003) identified an independent predictor Gleason score (GS) 8. Multivariate Cox regression analysis indicated that PSA level (hazard (HR): 1.024, 0.014), advanced GS (GS 8 8, HR: 3.253, 0.001) 1.941, 0.035) predictors BCR. For I determined by PET-imaging, shorter BCR-free survival higher (IA IB stage, log-rank, 0.022). Conclusion Preoperative correlates postoperative GS, time staging proposes novel non-invasive potentially serves ancillary pre-treatment stratification.