Efficacy of PSMA-radioguided surgery

In this phase II trial, the authors investigated the efficacy of prostate-specific membrane antigen (PSMA)-radioguided surgery in identifying lymph node invasion during robot-assisted radical prostatectomy in patients with clinically-localized prostate cancer. Overall, 12 patients with intermediate-or high-risk prostate cancer underwent the surgery, with 3 of 12 patients having lymph node involvement on final pathologic evaluation. As with preoperative PSMA imaging, the ability to detect nodal disease was plagued by poor sensitivity. In one patient, a 3-mm diameter lymph node identified on pathology was not identified. Given these early findings, the authors conclude that the use of PSMA-radioguided surgery is feasible and safe but there are limitations to the identification of micrometastatic lymph node involvement.

Euro Urol.2022 July 22. doi.org/10.1016/j.eururo.2022.06.002