Pd17-07 Can We Rely on Available Models Predicting Pathological Outcomes in Prostate Cancer Patients Staged With 68ga Psma-Pet/Ct? External Validation of the Existing Nomograms for Extracapsular Extension and Seminal Vesicle Invasion and Development of a Novel Tool Including Intraprostatic Suvmax

You have accessJournal of UrologyProstate Cancer: Staging I (PD17)1 May 2024PD17-07 CAN WE RELY ON AVAILABLE MODELS PREDICTING PATHOLOGICAL OUTCOMES IN PROSTATE CANCER PATIENTS STAGED WITH 68GA PSMA-PET/CT? EXTERNAL VALIDATION OF THE EXISTING NOMOGRAMS FOR EXTRACAPSULAR EXTENSION AND SEMINAL VESICLE INVASION AND DEVELOPMENT OF A NOVEL TOOL INCLUDING INTRAPROSTATIC SUVMAX Simone Scuderi, Giorgio Gandaglia, Pawel Rajwa, Juan Gomez Rivas, Lorenzo Bianchi, Claudia Kesch, Christopher Darr, Hongqian Guo, Junlong Zhuang, Fabio Zattoni, Wolfgang Fendler, Giancarlo Marra, Nicolai Huebner, Steven Joniau, Riccardo Schiavina, Agostino Mattei, Cristian Fiori, Francesco Porpiglia, Maria Picchio, Roderick van den Bergh, Shahrok Shariat, Arturo Chiti, Francesco Montorsi, and Alberto Briganti Simone ScuderiSimone Scuderi , Giorgio GandagliaGiorgio Gandaglia , Pawel RajwaPawel Rajwa , Juan Gomez RivasJuan Gomez Rivas , Lorenzo BianchiLorenzo Bianchi , Claudia KeschClaudia Kesch , Christopher DarrChristopher Darr , Hongqian GuoHongqian Guo , Junlong ZhuangJunlong Zhuang , Fabio ZattoniFabio Zattoni , Wolfgang FendlerWolfgang Fendler , Giancarlo MarraGiancarlo Marra , Nicolai HuebnerNicolai Huebner , Steven JoniauSteven Joniau , Riccardo SchiavinaRiccardo Schiavina , Agostino MatteiAgostino Mattei , Cristian FioriCristian Fiori , Francesco PorpigliaFrancesco Porpiglia , Maria PicchioMaria Picchio , Roderick van den BerghRoderick van den Bergh , Shahrok ShariatShahrok Shariat , Arturo ChitiArturo Chiti , Francesco MontorsiFrancesco Montorsi , and Alberto BrigantiAlberto Briganti View All Author Informationhttps://doi.org/10.1097/01.JU.0001010044.70939.31.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Existing multivariable models predicting seminal vesicle invasion (SVI) and extracapsular extension (ECE) in prostate cancer (PCa) patients undergoing radical prostatectomy (RP) have never been validated in the PSMA era. We hypothesized that the intraprostatic SUVmax (iSUVmax) values in patients staged with 68Ga-PSMA-PET/CT might improve models' performances. METHODS: A total 328 men staged with 68Ga-PSMA-PET/CT and treated with RP±pelvic lymph node dissection (pLND) at 7 referral centers between 2016 and 2023 were identified. Existing models based on preoperative PSA, ISUP Grade Group (GG), the presence of ECE or SVI at mpMRI, the maximum diameter of the index lesion at MRI, and the percentage of cores with ISUP GG ≥2 at systematic biopsy were externally validated. Loess function graphically explored the relationship between the iSUVmax and the risk of ECE and SVI. Novel models based on the coefficients of the previously mentioned variables with the addition of the SUVmax were developed to predict ECE and SVI. Model's performances were assessed with the ROC-derived AUC, calibration plot, and decision-curve analyses (DCAs). RESULTS: The median iSUVmax was 11.2. Overall, 186 (59%) and 62 (20%) patients had ECE and SVI. The existing models' discriminations were 60% for ECE and 71% for SVI at external validation. At multivariable analyses, iSUVmax was significantly associated with ECE (OR 1.05, 95% CI 1.01-1.09, p=0.01) and SVI (OR 1.03, 95% CI 1.00-1.06, p=0.04) after adjusting for confounders. Given the presence of a non-linear relationship between iSUVmax and ECE and SVI, iSUVmax as a restricted cubic spline term was incorporated into the two new prediction models. The new models showed higher discrimination for ECE (66%) and SVI (75%), better calibration and a higher net benefit compared to the available ones. CONCLUSIONS: In patients staged with 68Ga-PSMA-PET/CT, the addition of iSUVmax improved the performances of two validated models predicting adverse pathologic outcomes. 68Ga-PSMA-PET features, such as iSUVmax, should be considered for preoperative risk assessment. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e372 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Simone Scuderi More articles by this author Giorgio Gandaglia More articles by this author Pawel Rajwa More articles by this author Juan Gomez Rivas More articles by this author Lorenzo Bianchi More articles by this author Claudia Kesch More articles by this author Christopher Darr More articles by this author Hongqian Guo More articles by this author Junlong Zhuang More articles by this author Fabio Zattoni More articles by this author Wolfgang Fendler More articles by this author Giancarlo Marra More articles by this author Nicolai Huebner More articles by this author Steven Joniau More articles by this author Riccardo Schiavina More articles by this author Agostino Mattei More articles by this author Cristian Fiori More articles by this author Francesco Porpiglia More articles by this author Maria Picchio More articles by this author Roderick van den Bergh More articles by this author Shahrok Shariat More articles by this author Arturo Chiti More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ...