Attention: Restrictions on use of AUA, AUAER, and UCF content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.

JU INSIGHT Intraductal Prostate Cancer Lymphatic Pattern of Metastasis

By: Rui Bernardino, MD, University of Toronto, Princess Margaret Cancer Centre, Ontario, Canada, Computational and Experimental Biology Group, Nova Medical School, Lisbon, Portugal; Rashid K. Sayyid, MD, MSc, University of Toronto, Princess Margaret Cancer Centre, Ontario, Canada; Katherine Lajkosz, MSc, University Health Network, Toronto, Ontario, Canada; Zizo Al-Daqqaq, BScN, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Raj Tiwari, MD, FRCS, University of Toronto, Princess Margaret Cancer Centre, Ontario, Canada; Jessica Cockburn, PhD, University of Toronto, Princess Margaret Cancer Centre, Ontario, Canada; Ricardo Leão, MD, PhD, Cuf Hospitais, Faculty of Medicine University of Coimbra, Portugal; Ur Metser, MD, University Health Network, Toronto, Ontario, Canada; Alejandro Berlin, MD, PhD, University of Toronto, Princess Margaret Cancer Centre, Ontario, Canada; Theodorus van der Kwast, MD, PhD, University of Toronto, Toronto, Ontario, Canada; Neil E. Fleshner, MD, MPH, University of Toronto, Princess Margaret Cancer Centre, Ontario, Canada | Posted on: 19 Apr 2024

Bernardino R, Sayyid RK, Lajkosz K, et al. Intraductal prostate cancer affinity for lymphatic-predominant metastases through 18F-DCFPyL—prostate-specific membrane antigen—positron emission tomography/CT scans in pretreatment prostate cancer patients. J Urol. 2024;211(4):586-593.

Study Need and Importance

The detection of intraductal prostate cancer (IDC) in a sample is commonly correlated with a significant cancer volume, advanced stage of the disease, high Gleason score, and elevated risk of recurrence. The growing utilization of prostate-specific membrane antigen (PSMA)—positron emission tomography (PET)/CT scans in pretreatment settings has revealed novel patterns of metastatic spread. It this regard, it is important to determine whether presence of IDC in prostate biopsy is associated with an increased incidence of overall metastasis on PSMA-PET/CT and, specifically among those with metastatic disease, whether there is a propensity for lymphatic involvement (Figure).

image

Figure. Flowchart of the study. PSMA-PET indicates prostate-specific membrane antigen–positron emission tomography; PREP, PSMA-PET for Recurrent Prostate Cancer.

What We Found

We found that presence of IDC in prostate biopsy appears to be a marker for lymph node metastasis on 18F-DCFPyL-PET/CT.

Limitations

Limitations to this study include its single-center setting. Targeted biopsies for histologic confirmation of prostate cancer metastases and for presence of IDC morphology in the involved nodes were not performed in this trial.

Interpretation for Patient Care

The identification of IDC as a nodal metastasis marker holds substantial clinical value in enhancing patient stratification before radical treatment. This enables clinicians to ascertain the individuals who would derive maximum benefit from PSMA-PET scanning, contributing to enhanced cost-effectiveness in imaging strategies and, ultimately, better patient outcomes.

advertisement

advertisement