Open AccessCribriform pattern disease over‐represented in pelvic lymph node metastases identified on 68 GA PSMA‐PET/CT
Author(s) -
Bolton Damien,
Hong Anne,
Papa Nathan,
Perera Marlon,
Kelly Brian,
Duncan Catriona,
Clouston David,
Lawrentschuk Nathan
Publication year - 2022
Publication title -
bjui compass
Language(s) - English
Resource type - Journals
ISSN - 2688-4526
DOI - 10.1002/bco2.151
Subject(s) - medicine , lymph node , prostate cancer , cribriform , prostatectomy , lymph , biopsy , dissection (medical) , lymphadenectomy , pathology , cancer , radiology , carcinoma
Objectives To determine whether any specific histologic subtype of prostate cancer was preferentially represented in pelvic lymph node metastases identified on 68 GA‐PSMA‐PET/CT. Subjects and Methods A consecutive series of 66 men with biochemical recurrent prostate cancer was evaluated with 68 GA‐PSMA‐PET/CT. Where disease was confined to pelvic lymph nodes, patients were offered salvage extended pelvic lymph node dissection. Twenty patients ultimately proceeded to extended bilateral template pelvic lymph node dissection. Lymph node positivity and the histologic subtype of apparent cancer were assessed, as was PSA response to this intervention. Results Mean PSA at time of PSMA scanning for patients undergoing lymphadenectomy was 2.49 ( n = 20, range 0.21–12.0). In 16 of 20 patients, there was evidence of metastatic cribriform pattern prostate cancer in excised nodes (100% cribriform pattern in 11/16). Only four of 20 patients had no evidence of this histologic subtype of disease. PSA response was not related to the presence or proportional amount of cribriform pattern disease identified. Conclusions Cribriform pattern adenocarcinoma appears to be the histologic subtype preferentially identified in pelvic lymph nodes on 68 GA‐PSMA‐PET/CT. The use of PSMA‐PET may be particularly valuable in staging of primary or biochemically recurrent prostate cancer in patients with cribriform pattern disease detected on initial biopsy or radical prostatectomy. Further research is required to further confirm the observed association.