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Negative predictive value of PSMA PET scan for lymph node staging in patients undergoing robotic radical prostatectomy and pelvic lymph node dissection

  • Urology - Original Paper
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Abstract

Purpose

To assess the negative predictive value of PSMA PET scan for lymph node staging in patients undergoing robotic radical prostatectomy and pelvic lymph node dissection.

Materials and methods

A retrospective analysis of patients who underwent robotic-assisted radical prostatectomy with pelvic lymph node dissection and had a preoperative negative PSMA PET scan for metastasis was performed. The documented pre-operative variables studied included age, BMI, PSA at diagnosis, Gleason score, and biopsy ISUP grades. Patients were categorised as low, intermediate and high risk according to the D Amico classification. The post-op variables included were number of lymph nodes harvested, number of positive nodes, positivity rate, size of the node metastasis, T staging and ISUP grading.

Results

The overall negative predictive value of PSMA PET scan was 71.6%. Further sub-classification according to risk stratification demonstrated a NPV of 58.02%, 92.7% and 90% for high, intermediate and low risk, respectively.

Conclusion

Pelvic lymph node dissection cannot be excluded based on a negative preop PSMA PET/CT scan.

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Data availability

Ms Carmel Regeela Mainu TT, Mr. Adarsh M Kurup.

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Funding

Intramural funds from Aster DM healthcare.

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Authors and Affiliations

  1. Aster Medcity, Kochi, India

    Kishore Thekke Adiyat, Dinesh Thomas Cherian & Shagos Gopalan Nair Santhamma

  2. Amrita Institute of Medical Sciences, Kochi, India

    Ginil Kumar Pooleri, K Ravichandran & Shanmuga Sundaram

  3. Department of Urology, Aster Medcity, Kuttisahib Road, Cheranelloor, Ernakulam, Kerala, 682027, India

    Kishore Thekke Adiyat

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  1. Kishore Thekke Adiyat
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  2. Ginil Kumar Pooleri
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  3. Dinesh Thomas Cherian
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Correspondence to Kishore Thekke Adiyat.

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Adiyat, K.T., Pooleri, G.K., Cherian, D.T. et al. Negative predictive value of PSMA PET scan for lymph node staging in patients undergoing robotic radical prostatectomy and pelvic lymph node dissection. Int Urol Nephrol 55, 1453–1457 (2023). https://doi.org/10.1007/s11255-023-03595-0

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